Craig A Ross, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G28225 Issued in CA

Practice address

16480 Harbor Blvd
Suite 104
Fountain Valley, CA 92708-1361

Phone

(714) 775-0777

Fax

(714) 775-1026

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• South Coast Therapists, Inc.

  • Mental Health Counselor
  • Fountain Valley, CA
  • NPI 1194872382
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215928221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4166",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926054166",
            "telephone_number": "714-775-0777",
            "fax_number": "714-775-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16480 HARBOR BLVD",
            "address_2": "SUITE 104",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081361",
            "telephone_number": "714-775-0777",
            "fax_number": "714-775-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CRAIG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G28225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G282250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald J Policastro MD Inc
• Rose Point Acupuncture Inc
• Thomas P. Rose, D.D.S., M.S.
• Rosemary R. Jadia, D.P.M.
• Abigail Lee Ross
• Kayla Renee Rosu, RBT
• Julia Anne Rotino, B.S.
• Alexis Rubin
• Ivan Rudenko, MD
• Monica Isabel Ruiz Pinto

• Psychiatry Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.