Active NPI
Freddie Cavasos Jr., PSY.D.
- Clinical Psychologist
- Visalia, CA
National Provider Identifier
1215691092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34724
- Practice address
- 520 E Tulare Ave
Visalia, CA 93292-3629 - Phone
- (559) 623-0952
- NPI assigned
- Oct 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | |||
| Clinical Psychologist | 103TC0700X | 34724 | CA | Primary |
Addresses
Primary practice location
520 E Tulare Ave
Visalia, CA 93292-3629
Mailing address
520 E Tulare Ave
Visalia, CA 93292-3629
Phone (559) 623-0952
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34724 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703462400000",
"number": "1215691092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 E TULARE AVE",
"city": "VISALIA",
"state": "CA",
"postal_code": "932923629",
"telephone_number": "559-623-0952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 E TULARE AVE",
"city": "VISALIA",
"state": "CA",
"postal_code": "932923629",
"telephone_number": "559-623-0952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVASOS",
"first_name": "FREDDIE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-27",
"last_updated": "2023-12-25",
"certification_date": "2023-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "34724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Visalia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.