Individual provider Active NPI

Rebecca Van Sickle, PH.D.

  • Psychologist
  • San Bernardino, CA
National Provider Identifier
1215353552
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
900 E Gilbert St Ste 4
San Bernardino, CA 92415-8515
Phone
(909) 387-7406
NPI assigned
Mar 11, 2014
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

900 E Gilbert St Ste 4
San Bernardino, CA 92415-8515

Mailing address

1348 Ram LN
Fallbrook, CA 92028-8245
Phone (951) 816-7910

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
I20240829002965 CA Practitioner - Clinical Psychologist 7315486636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Total Life Ca PCGroup PAC ID 3173989332, 34 clinicians

Practice addresses (Care Compare)

6080 Ctr Dr
FL 6
Los Angeles, CA 90045-9205
Phone (800) 567-5433

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Total Life Ca, P.C. CurrentSince Aug 1, 2024 Accepting new patients

Locations

6080 Center Dr
Fl 6
Westchester, CA 90045
Phone (669) 231-6870

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": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1215353552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 RAM LN",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920288245",
            "telephone_number": "951-816-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E GILBERT ST STE 4",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924158515",
            "telephone_number": "909-387-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SICKLE",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.