Active NPI
Robert Clark Boyle, PSY.D
- Psychologist
- Redding, CA
National Provider Identifier
1164633756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY119900
- Practice address
- 429 Redcliff Dr
Suite 225
Redding, CA 96002-0167 - Phone
- (530) 524-4036
- Fax
- (866) 576-5971
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY119900 | CA | Primary |
Addresses
Primary practice location
429 Redcliff Dr
Suite 225
Redding, CA 96002-0167
Mailing address
PO Box 991826
Redding, CA 96099-1826
Phone (530) 244-5833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY11990 | Other | CA | PSYCHOLOGIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY119900 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TCS Medical Group Inc | 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.
-
- Specialist
- Redding, CA
- NPI 1154404085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374537600000",
"number": "1164633756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 991826",
"city": "REDDING",
"state": "CA",
"postal_code": "960991826",
"telephone_number": "530-244-5833",
"fax_number": "866-647-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "429 REDCLIFF DR",
"address_2": "SUITE 225",
"city": "REDDING",
"state": "CA",
"postal_code": "960020167",
"telephone_number": "530-524-4036",
"fax_number": "866-576-5971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLE",
"first_name": "ROBERT",
"middle_name": "CLARK",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2013-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY119900",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST",
"identifier": "PSY11990",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.