Individual provider Active NPI

Tina Ventura Glueck, PH.D.

  • Clinical Psychologist
  • Pleasanton, CA
National Provider Identifier
1265761159
Registry record updated Dec 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20858 Issued in CA
Practice address
7901 Stoneridge Dr
Suite 521
Pleasanton, CA 94588-3677
Phone
(925) 463-3500
NPI assigned
Dec 24, 2009
Last updated
Dec 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2009

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 PSY20858 CA Primary

Addresses

Primary practice location

7901 Stoneridge Dr
Suite 521
Pleasanton, CA 94588-3677

Mailing address

7901 Stoneridge Dr.
Suite 521
Pleasanton, CA 94588
Phone (925) 463-3500

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
I20100302000220 CA Practitioner - Clinical Psychologist 0042355018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Del Valle Clinic IncGroup PAC ID 2961539846, 2 clinicians

Practice addresses (Care Compare)

1797 4TH St
Livermore, CA 94550-4347
Phone (925) 443-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY20858CAMDClinical Psychologist
20858CAMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1265761159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 STONERIDGE DR.",
            "address_2": "SUITE 521",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "94588",
            "telephone_number": "925-463-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 STONERIDGE DR",
            "address_2": "SUITE 521",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883677",
            "telephone_number": "925-463-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUECK",
        "first_name": "TINA",
        "middle_name": "VENTURA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-24",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.