Active NPI
Joseph Bacchus, PSY.D.
- Psychologist
- Coalinga, CA
National Provider Identifier
1194908962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY25681
- Practice address
- 24511 W. Jayne Ave.
Coalinga, CA 93210 - Phone
- (559) 934-8077
- NPI assigned
- Dec 14, 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 | PSY25681 | CA | Primary |
Addresses
Primary practice location
24511 W. Jayne Ave.
Coalinga, CA 93210
Mailing address
3065 N Marty Ave Apt 126
Fresno, CA 93722-4734
Phone (559) 271-7520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1600 9TH St
Suite 150
Sacramento, CA 95814-6402
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25681 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488499200000",
"number": "1194908962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3065 N MARTY AVE APT 126",
"city": "FRESNO",
"state": "CA",
"postal_code": "937224734",
"telephone_number": "559-271-7520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24511 W. JAYNE AVE.",
"city": "COALINGA",
"state": "CA",
"postal_code": "93210",
"telephone_number": "559-934-8077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACCHUS",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-14",
"last_updated": "2017-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY25681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coalinga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.