Carolyn Quisenberry, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29419 Issued in CA

Practice address

15525 Pomerado Rd Ste B3
Poway, CA 92064-2425

Phone

(760) 607-6463

Fax

(760) 607-3433

NPI assigned

May 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• I Don'T DO Addictive Drugs

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Poway, CA
  • NPI 1376065433
  NPD (past)
• San Diego Psychological Center Inc.

  • Psychologist
  • Poway, CA
  • NPI 1083003586
  NPD (past)

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1255710893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD STE B3",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642425",
            "telephone_number": "760-607-6463",
            "fax_number": "760-607-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD STE B3",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642425",
            "telephone_number": "760-607-6463",
            "fax_number": "760-607-3433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3002 Armstrong St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921115702",
            "country_code": "US",
            "telephone_number": "858-277-9550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUISENBERRY",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Lee Putnam, MD
• Brian Lin Quach, P.T., D.P.T.
• Lashayla Qualls
• Steven Quintanar
• Sim Jeia Rose Bareng Quinzon
• Kimberly Rabadan
• William Paul Racicot, D.D.S.
• Rafael Infante D.D.S. Inc
• Rafik Riad DDS Inc
• Tranisha Rainey

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.