Individual provider Active NPI

Rochelle Theresa Bastien, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1154341386
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 9043 Issued in CA
Practice address
9040 Friars Rd
Ste 420
San Diego, CA 92108-5899
Phone
(619) 285-1323
Fax
(619) 284-6770
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 9043 CA Primary

Addresses

Primary practice location

9040 Friars Rd
Ste 420
San Diego, CA 92108-5899

Mailing address

9040 Friars Rd
Suite 420
San Diego, CA 92108-5899
Phone (619) 285-1323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051018000596 CA Practitioner - Clinical Psychologist 6406872662 Practice locations: Imperial Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of California, Geffen School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

714 Seacoast Dr
Unit 103
Imperial Beach, CA 91932-1867
Phone (619) 285-1323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 9043CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1154341386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 FRIARS RD",
            "address_2": "SUITE 420",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085899",
            "telephone_number": "619-285-1323",
            "fax_number": "619-284-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 FRIARS RD",
            "address_2": "STE 420",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085899",
            "telephone_number": "619-285-1323",
            "fax_number": "619-284-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIEN",
        "first_name": "ROCHELLE",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 9043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.