Active NPI
Michael P Sloan, PHD
- Clinical Psychologist
- Banning, CA
National Provider Identifier
1205902954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY8604
- Practice address
- 264 N Highland Springs Ave
Ste 1C
Banning, CA 92220-3045 - Phone
- (951) 845-8262
- Fax
- (951) 845-6458
- NPI assigned
- Nov 27, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY8604 | CA | Primary |
Addresses
Primary practice location
264 N Highland Springs Ave
Ste 1C
Banning, CA 92220-3045
Mailing address
264 N Highland Springs Ave
Ste 1C
Banning, CA 92220-3045
Phone (951) 845-8262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY086040 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120215000309 | CA | Practitioner - Psychologist Billing Independently | 2860650223 | Practice locations: Banning, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
264 N Highland Springs Ave
Suite 1C
Banning, CA 92220-3045
Phone (951) 845-8262
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8604 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488931200000",
"number": "1205902954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 N HIGHLAND SPRINGS AVE",
"address_2": "STE 1C",
"city": "BANNING",
"state": "CA",
"postal_code": "922203045",
"telephone_number": "951-845-8262",
"fax_number": "951-845-6458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 N HIGHLAND SPRINGS AVE",
"address_2": "STE 1C",
"city": "BANNING",
"state": "CA",
"postal_code": "922203045",
"telephone_number": "951-845-8262",
"fax_number": "951-845-6458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLOAN",
"first_name": "MICHAEL",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2017-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY8604",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY086040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.