Individual provider Active NPI

Carolyn Anne Mottola, PHD

  • Psychologist
  • Anaheim, CA
National Provider Identifier
1174504138
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY10163 Issued in CA
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

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
OPL101631OtherCABLUE SHIELD
4124629OtherCAAETNA
077554OtherCAMANAGED 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

LicenseStateTypeSpecialty
PSY10163CAMDPsychologist

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.

Verify at the official NPI Registry.