NPIMap

Individual provider Active NPI

Emily Elizabeth Perrine, PSYD

  • Clinical Psychologist
  • Imperial Beach, CA
National Provider Identifier
1114070265
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
CAPSY23363 Issued in CA
Practice address
1320 Seacoast Drive
Unit M
Imperial Beach, CA 91932-3193
Phone
(619) 925-9875
NPI assigned
Jan 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X RPS2006169 CA
Clinical Psychologist 103TC0700X PSB32507 CA
Clinical Psychologist 103TC0700X CAPSY23363 CA Primary

Addresses

Primary practice location

1320 Seacoast Drive
Unit M
Imperial Beach, CA 91932-3193

Mailing address

1320 Seacoast Drive
Unit M
Imperial Beach, CA 91932-3193
Phone (619) 925-9875

Other names 1

  • Dr. Emily Molina Gifford Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CAPSY23363CAMDClinical Psychologist
PSB32507CAMDClinical Psychologist
RPS2006169CAMDClinical Psychologist
23363CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Institute of Pinole Past Accepting new patients
The Family Institute of Richmond Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1114070265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 SEACOAST DRIVE",
            "address_2": "UNIT M",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919323193",
            "telephone_number": "619-925-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 SEACOAST DRIVE",
            "address_2": "UNIT M",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919323193",
            "telephone_number": "619-925-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRINE",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "RPS2006169",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB32507",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "CAPSY23363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "GIFFORD",
            "middle_name": "MOLINA",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Imperial Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.