John Ponder, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22104 Issued in CA

Practice address

20430 Brian Way
Suite 2
Tehachapi, CA 93561

Phone

(619) 813-7154

NPI assigned

Aug 20, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1255588307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935810091",
            "telephone_number": "619-813-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20430 BRIAN WAY",
            "address_2": "SUITE 2",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "93561",
            "telephone_number": "619-813-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY22104",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy C. Peterson, M.D.
• Dana Pettaway
• Christina Lynn Phillips, CMT
• Joshua Pierce, SUDCC
• Janice K Polletta, NP
• Wes Michael Powell
• Premier Emergency Physicians of California Medical Group PC
• Premier Medical Doctors Inc.
• William Frederick Prewett, DDS
• Kelly Price

• Clinical Psychologist in Tehachapi, CA
• Providers in Tehachapi, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.