Individual provider Active NPI

Tulip Mitchell, PSY.D.

  • Psychologist
  • Pasadena, CA
National Provider Identifier
1245328392
Registry record updated Apr 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY14272 Issued in CA
Practice address
532 E Colorado Blvd
8TH Floor
Pasadena, CA 91101-2044
Phone
(626) 229-3874
Fax
(626) 564-6082
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY14272 CA Primary

Addresses

Primary practice location

532 E Colorado Blvd
8TH Floor
Pasadena, CA 91101-2044

Mailing address

3961 Via Marisol
#109
Los Angeles, CA 90042-5084
Phone (626) 437-0139

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
I20120803000331 CA Practitioner - Clinical Psychologist 3870749096 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY14272CAMDPsychologist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1245328392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 VIA MARISOL",
            "address_2": "#109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900425084",
            "telephone_number": "626-437-0139",
            "fax_number": "323-222-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 E COLORADO BLVD",
            "address_2": "8TH FLOOR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012044",
            "telephone_number": "626-229-3874",
            "fax_number": "626-564-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TULIP",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY14272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.