Active NPI
Pegeen Mary Cronin, PHD
- Psychologist
- Ventura, CA
National Provider Identifier
1184731044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY16026
- Practice address
- 1802 Eastman Ave
Ventura, CA 93003-7701 - Phone
- (877) 428-8478
- Fax
- (877) 428-8478
- NPI assigned
- Aug 24, 2006
- 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 | PSY16026 | CA | Primary |
Addresses
Primary practice location
1802 Eastman Ave
Ventura, CA 93003-7701
Mailing address
PO Box 1723
Agoura Hills, CA 91376-1723
Phone (877) 428-8478
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY160260 | Medicaid | CA |
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1184731044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1723",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "913761723",
"telephone_number": "877-428-8478",
"fax_number": "877-428-8478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 EASTMAN AVE",
"city": "VENTURA",
"state": "CA",
"postal_code": "930037701",
"telephone_number": "877-428-8478",
"fax_number": "877-428-8478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRONIN",
"first_name": "PEGEEN",
"middle_name": "MARY",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY16026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY160260",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.