Active NPI
Carolyn Anne Mottola, PHD
- Psychologist
- Anaheim, CA
National Provider Identifier
1174504138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY10163
- Practice address
- 1020 S Anaheim Blvd
Suite 215
Anaheim, CA 92708 - Phone
- (714) 237-4440
- Fax
- (714) 839-7460
- NPI assigned
- Nov 8, 2005
- Sex
- Female
- Sole proprietor
- No
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 | PSY10163 | CA | Primary |
Addresses
Primary practice location
1020 S Anaheim Blvd
Suite 215
Anaheim, CA 92708
Mailing address
PO Box 8342
Huntington Beach, CA 92615-8342
Phone (714) 237-4440
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPL101631 | Other | CA | BLUE SHIELD |
| 4124629 | Other | CA | AETNA |
| 077554 | Other | CA | MANAGED HEALTH NETWORK |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY10163 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1174504138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8342",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926158342",
"telephone_number": "714-237-4440",
"fax_number": "714-839-7460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 S ANAHEIM BLVD",
"address_2": "SUITE 215",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "92708",
"telephone_number": "714-237-4440",
"fax_number": "714-839-7460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTTOLA",
"first_name": "CAROLYN",
"middle_name": "ANNE",
"name_prefix": "Miss",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY10163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "OPL101631",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4124629",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "077554",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.