Individual provider Active NPI

Christine Osterloh, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1184647687
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10172 Issued in CA
Practice address
3921 Goldfinch St
San Diego, CA 92103-2926
Phone
(619) 260-0335
Fax
(619) 260-1682
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY10172 CA Primary

Addresses

Primary practice location

3921 Goldfinch St
San Diego, CA 92103-2926

Mailing address

3921 Goldfinch St
San Diego, CA 92103-2926
Phone (619) 260-0335

Other identifiers 1

IdentifierTypeStateIssuer
PH0101720MedicaidCA

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
PSY10172CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184647687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 GOLDFINCH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032926",
            "telephone_number": "619-260-0335",
            "fax_number": "619-260-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 GOLDFINCH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032926",
            "telephone_number": "619-260-0335",
            "fax_number": "619-260-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERLOH",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY10172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH0101720",
            "state": "CA"
        }
    ],
    "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 Jul 8, 2007; 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.