Pacific Psychology Centers, Apc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 26899 Issued in CA

Legal business name

PACIFIC PSYCHOLOGY CENTERS, APC.

Practice address

2382 Faraday Ave Ste 250-12
Carlsbad, CA 92008-7218

Phone

(858) 869-9530

NPI assigned

Jan 19, 2015

Organization subpart

No

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

Authorized official

Name

Nichole Duarte, PH.D.NPI 1902039555

Title

Owner

Phone

(310) 592-9937

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nichole Antoinette Duarte, PH.D.

  • Clinical Psychologist
  • Carlsbad, CA
  • NPI 1902039555
  Medicare reassignment NPD Authorized official
• Stacy Kim Johnston, PHD

  • Clinical Psychologist
  • La Mesa, CA
  • NPI 1063569135
  Medicare reassignment Care Compare group NPD
• Jill Ann Saulque, PH.D.

  • Psychologist
  • Rancho Mirage, CA
  • NPI 1508122235
  Medicare reassignment Care Compare group NPD
• Fatemeh Javanmardi

  • Psychoanalysis Psychologist
  • Carlsbad, CA
  • NPI 1225711146
  NPD
• Dana Lynn Emmer, MSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1235258005
  NPD (past)
• Kelley Rogers, PHD

  • Professional Counselor
  • San Diego, CA
  • NPI 1225402902
  NPD (past)
• Victoria Rutledge, LPC 3308 MFTI75505

  • Mental Health Counselor
  • Carlsbad, CA
  • NPI 1205203114
  NPD (past)

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421625600000",
    "number": "1295124998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2382 FARADAY AVE STE 250-12",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920087218",
            "telephone_number": "858-869-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2382 FARADAY AVE STE 250-12",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920087218",
            "telephone_number": "858-869-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PSYCHOLOGY CENTERS, APC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-592-9937",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 26899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.