Individual provider Active NPI

Ralph Leonard Ames, PHD

  • Clinical Psychologist
  • Santa Rosa, CA
National Provider Identifier
1205994464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21089 Issued in CA
Practice address
865 Third St
# 203
Santa Rosa, CA 95404
Phone
(707) 508-6361
Fax
(707) 527-5395
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY21089 CA Primary

Addresses

Primary practice location

865 Third St
# 203
Santa Rosa, CA 95404

Mailing address

1055 West College Ave
# 439
Santa Rosa, CA 95401
Phone (707) 508-6361

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
I20070126000273 CA Practitioner - Clinical Psychologist 2567463086 Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

621 Cherry St
Suite 8
Santa Rosa, CA 95404-4202
Phone (707) 508-6361

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21089CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Redwood Psychology Center, Inc PastSince Jul 26, 2022 Accepting new patients
Redwood Psychology Center, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205994464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 WEST COLLEGE AVE",
            "address_2": "# 439",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95401",
            "telephone_number": "707-508-6361",
            "fax_number": "707-527-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 THIRD ST",
            "address_2": "# 203",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95404",
            "telephone_number": "707-508-6361",
            "fax_number": "707-527-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMES",
        "first_name": "RALPH",
        "middle_name": "LEONARD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.