Individual provider Active NPI

John Bellone, PHD

  • Clinical Neuropsychologist
  • Fullerton, CA
National Provider Identifier
1205328192
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
1440 N Harbor Blvd Ste 255
Fullerton, CA 92835-4127
Phone
(949) 783-9590
NPI assigned
Jun 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

1440 N Harbor Blvd Ste 255
Fullerton, CA 92835-4127

Mailing address

2773 Salem CT
San Bernardino, CA 92408-4135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725000985 CA Practitioner - Clinical Psychologist 2365799137 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
29457CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Seda Terzyan, a Psychological Corporation CurrentSince Nov 15, 2020 Accepting new patients

Locations

1550 Bayside Dr
Corona del Mar, CA 92625
Phone (949) 280-7729

1440 N Harbor Blvd
Ste 255
Fullerton, CA 92835
Phone (909) 239-9738

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1205328192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2773 SALEM CT",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 255",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354127",
            "telephone_number": "949-783-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLONE",
        "first_name": "JOHN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.