Organization Active NPI

Joan M. Ybarra, PSYD., a Psychological Corporation

  • Clinical Psychologist
  • Covina, CA
National Provider Identifier
1164520656
Registry record updated Jan 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 16627 Issued in CA
Legal business name
JOAN M. YBARRA, PSYD., A PSYCHOLOGICAL CORPORATION
Practice address
599 S Barranca Ave
Suite 221
Covina, CA 91723-2777
Phone
(909) 573-7660
Fax
(626) 912-6235
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2020

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

Authorized official

Name
Dr. Joan M YbarraNPI 1851730915
Title
President
Phone
(909) 573-7660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY 16627 CA Primary

Addresses

Primary practice location

599 S Barranca Ave
Suite 221
Covina, CA 91723-2777

Mailing address

599 S Barranca Ave
Suite 221
Covina, CA 91723-2777
Phone (909) 573-7660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200107002480 CA Part B Supplier - Clinic/Group Practice 4789709148 Receives reassigned benefits from 1 practitioner
Practice locations: Diamond Bar, CA

National Provider Directory

National Provider Directory

Locations

556 N Diamond Bar Blvd
Ste 103
Diamond Bar, CA 91765
Phone (909) 573-7660

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579996800000",
    "number": "1164520656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 S BARRANCA AVE",
            "address_2": "SUITE 221",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232777",
            "telephone_number": "909-573-7660",
            "fax_number": "626-912-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 S BARRANCA AVE",
            "address_2": "SUITE 221",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232777",
            "telephone_number": "909-573-7660",
            "fax_number": "626-912-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOAN M. YBARRA, PSYD., A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-01-26",
        "certification_date": "2020-01-26",
        "status": "A",
        "authorized_official_last_name": "YBARRA",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-573-7660",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 16627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.