Active NPI
Christopher Sample, PSYD
- Clinical Psychologist
- Newport Beach, CA
National Provider Identifier
1205335973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY29870
- Practice address
- 4000 Macarthur Blvd Ste 600
Newport Beach, CA 92660-2517 - Phone
- (949) 449-1335
- NPI assigned
- Feb 7, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY29870 | CA | Primary |
Addresses
Primary practice location
4000 Macarthur Blvd Ste 600
Newport Beach, CA 92660-2517
Mailing address
4000 Macarthur Blvd
East Tower, Suite 600
Newport Beach, CA 92649-2347
Phone (703) 244-4815
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY29870 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1205335973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 MACARTHUR BLVD",
"address_2": "EAST TOWER, SUITE 600",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926492347",
"telephone_number": "703-244-4815",
"fax_number": "949-209-4544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 MACARTHUR BLVD STE 600",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602517",
"telephone_number": "949-449-1335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLE",
"first_name": "CHRISTOPHER",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-07",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY29870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.