NPIMap

Organization Active NPI

Grand Terrace Psychological Services, Inc.

Doing business as California Behavioral Care

  • Psychologist
  • Redlands, CA
National Provider Identifier
1275669475
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY10385 Issued in CA
Legal business name
GRAND TERRACE PSYCHOLOGICAL SERVICES, INC.
Doing business as
California Behavioral Care
Practice address
721 Nevada St Ste 203
Redlands, CA 92373-8051
Phone
(909) 798-5669
Fax
(909) 335-9219
NPI assigned
Feb 24, 2007
Last updated
Jun 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Authorized official

Name
Dr. Edward B Pflaumer, PH.D.NPI 1801084561
Title
Owner
Phone
(909) 899-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY10385 CA Primary

Addresses

Primary practice location

721 Nevada St Ste 203
Redlands, CA 92373-8051

Mailing address

Post Office Box 950
Rancho Cucamonga, CA 91729
Phone (909) 899-6800

Other identifiers 2

IdentifierTypeStateIssuer
PSY10385OtherCALICENSE NUMBER
GPS001160MedicaidCA

Other names 1

  • California Behavioral Care Doing business as

National Provider Directory

National Provider Directory

Locations

721 Nevada St
Ste 203
Redlands, CA 92373
Phone (909) 335-9119

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1275669475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 950",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91729",
            "telephone_number": "909-899-6800",
            "fax_number": "909-899-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 NEVADA ST STE 203",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738051",
            "telephone_number": "909-798-5669",
            "fax_number": "909-335-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TERRACE PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-24",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "PFLAUMER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-899-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY10385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PSY10385",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPS001160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Behavioral Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.