Pauline Nne Ubani

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSB94024356 Issued in CA

Practice address

17215 Studebaker Rd Ste 110
Cerritos, CA 90703-2521

Phone

(562) 860-2210

Fax

(562) 860-1154

NPI assigned

Oct 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1265076715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17215 STUDEBAKER RD STE 110",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032521",
            "telephone_number": "562-860-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17215 STUDEBAKER RD STE 110",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032521",
            "telephone_number": "562-860-2210",
            "fax_number": "562-860-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UBANI",
        "first_name": "PAULINE",
        "middle_name": "NNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94024356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PSYCHOLOGY",
            "identifier": "PSB94024356",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.