Active NPI
Donna McCullough, PHD
- Psychologist
- Laguna Hills, CA
National Provider Identifier
1205916129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY14793
- Practice address
- 23121 Plaza Pointe Dr
Suite 108
Laguna Hills, CA 92653-1461 - Phone
- (949) 246-7724
- Fax
- (714) 899-4275
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- 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 | PSY14793 | CA | Primary |
Addresses
Primary practice location
23121 Plaza Pointe Dr
Suite 108
Laguna Hills, CA 92653-1461
Mailing address
23121 Plaza Pointe Dr
Suite 108
Laguna Hills, CA 92653-1461
Phone (949) 246-7724
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070515000313 | CA | Practitioner - Clinical Psychologist | 5092812743 | Practice locations: Laguna Hills, CA; Mission Viejo, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
23121 Plaza Pointe Dr
Suite 108
Laguna Hills, CA 92653-1466
Phone (949) 246-7724
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY14793 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488153600000",
"number": "1205916129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23121 PLAZA POINTE DR",
"address_2": "SUITE 108",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926531461",
"telephone_number": "949-246-7724",
"fax_number": "714-899-4275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23121 PLAZA POINTE DR",
"address_2": "SUITE 108",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926531461",
"telephone_number": "949-246-7724",
"fax_number": "714-899-4275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "DONNA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2017-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY14793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.
- 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.