Individual provider Active NPI

Michael J. Chindamo, PSY.D

  • Clinical Psychologist
  • Long Beach, CA
National Provider Identifier
1245556000
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22472 Issued in CA
Practice address
4500 E Pacific Coast Hwy Ste 320
Long Beach, CA 90804-3271
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Apr 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22472 CA Primary

Addresses

Primary practice location

4500 E Pacific Coast Hwy Ste 320
Long Beach, CA 90804-3271

Mailing address

4500 E Pacific Coast Hwy Ste 320
Long Beach, CA 90804-3271
Phone (925) 282-1778

Other practice location 1

2327 Chestnut Ave
Long Beach, CA 90806-4211
Phone (562) 897-1972

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
I20100628001064 CA Practitioner - Clinical Psychologist 3375674716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

4500 E Pacific Coast Hwy
Suite 320
Long Beach, CA 90804-3271
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Mar 19, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

4500 E Pacific Coast Hwy
Ste 320
Long Beach, CA 90804
Phone (802) 763-2453

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1245556000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 E PACIFIC COAST HWY STE 320",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043271",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 E PACIFIC COAST HWY STE 320",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043271",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2327 Chestnut Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908064211",
            "country_code": "US",
            "telephone_number": "562-897-1972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHINDAMO",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.