Active NPI
Alexandra Massimillo Webster, PSY.D.
- Psychologist
- Chino, CA
National Provider Identifier
1205559473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34588
- Practice address
- 14901 Central Ave
Chino, CA 91710-9500 - Phone
- (909) 597-1821
- NPI assigned
- Sep 22, 2022
- 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 | 34588 | CA | Primary |
Addresses
Primary practice location
14901 Central Ave
Chino, CA 91710-9500
Mailing address
2420 E 5TH St Apt 15
Long Beach, CA 90814-3581
Phone (516) 428-8436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251211000528 | NY | Order and Referring Only - Clinical Psychologist | 2860986478 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34588 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1205559473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2420 E 5TH ST APT 15",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908143581",
"telephone_number": "516-428-8436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14901 CENTRAL AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "917109500",
"telephone_number": "909-597-1821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBSTER",
"first_name": "ALEXANDRA",
"middle_name": "MASSIMILLO",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-22",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "34588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.