Individual provider Active NPI

John Pellitteri, PSY.D.

  • Clinical Neuropsychologist
  • Claremont, CA
National Provider Identifier
1285857029
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY17624 Issued in CA
Practice address
250 W 1St St Ste 242
Claremont, CA 91711-4742
Phone
(909) 941-1669
Fax
(909) 941-1669
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY17624 CA Primary
Psychologist 103T00000X PSY17624 CA
Clinical Psychologist 103TC0700X PSY17624 CA

Addresses

Primary practice location

250 W 1St St Ste 242
Claremont, CA 91711-4742

Mailing address

9766 19TH St # 206
Alta Loma, CA 91737-3538
Phone (909) 941-1669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY17624CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1285857029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9766 19TH ST # 206",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917373538",
            "telephone_number": "909-941-1669",
            "fax_number": "909-941-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 1ST ST STE 242",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114742",
            "telephone_number": "909-941-1669",
            "fax_number": "909-941-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLITTERI",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY17624",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY17624",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.