Active NPI
Deanna Reardon, PSY.D.
- Clinical Psychologist
- Nevada City, CA
National Provider Identifier
1225125826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 19231
- Practice address
- 123 Nevada St
Nevada City, CA 95959-2603 - Phone
- (510) 420-8092
- Fax
- (206) 350-0343
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 19231 | CA | Primary |
Addresses
Primary practice location
123 Nevada St
Nevada City, CA 95959-2603
Mailing address
3852 Piedmont Ave
Oakland, CA 94611-5353
Phone (510) 420-8092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444867200000",
"number": "1225125826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3852 PIEDMONT AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115353",
"telephone_number": "510-420-8092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 NEVADA ST",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959592603",
"telephone_number": "510-420-8092",
"fax_number": "206-350-0343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "DEANNA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2015-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "19231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nevada City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.