Individual provider Active NPI

Taeko Uchino-Dicarlo, PSY.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1215139993
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY22506 Issued in CA
Practice address
8765 Aero Dr Ste 228
San Diego, CA 92123-1785
Phone
(858) 876-7779
Fax
(619) 272-7542
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY22506 CA Primary

Addresses

Primary practice location

8765 Aero Dr Ste 228
San Diego, CA 92123-1785

Mailing address

3111 Camino del Rio N Ste 400
San Diego, CA 92108-5724
Phone (858) 876-7779

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
I20091214000488 CA Practitioner - Clinical Psychologist 8921148404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Positive Psychology IncGroup PAC ID 4981820347, 2 clinicians

Practice addresses (Care Compare)

8765 Aero Dr
Suite 228
San Diego, CA 92123-1785
Phone (858) 876-7779

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY22506CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Psychology Inc. Psychologist CurrentSince Mar 31, 2014 Accepting new patients

Locations

3111 Camino del Rio N
Ste 400
San Diego, CA 92108
Phone (858) 244-5176

8765 Aero Dr
Ste 228
San Diego, CA 92123
Phone (619) 776-9408

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1215139993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 CAMINO DEL RIO N STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085724",
            "telephone_number": "858-876-7779",
            "fax_number": "619-272-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 AERO DR STE 228",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231785",
            "telephone_number": "858-876-7779",
            "fax_number": "619-272-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UCHINO-DICARLO",
        "first_name": "TAEKO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.