Individual provider Active NPI

Chris Beletsis, PH.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1154748788
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 11683 Issued in CA
Practice address
480 Alta Rd
San Diego, CA 92179-0001
Phone
(619) 661-6500
NPI assigned
Mar 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 11683 CA Primary

Addresses

Primary practice location

480 Alta Rd
San Diego, CA 92179-0001

Mailing address

480 Alta Rd
San Diego, CA 92179-0001
Phone (619) 661-6500

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 11683CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of California Prison Industry Authority Past Accepting new patients

Organizations & group practices 1

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": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1154748788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921790001",
            "telephone_number": "619-661-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921790001",
            "telephone_number": "619-661-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELETSIS",
        "first_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 11683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.