Individual provider Active NPI

Carole M. Matlen, PH.D.

  • Clinical Psychologist
  • Tehachapi, CA
National Provider Identifier
1295806826
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY17461 Issued in CA
Practice address
24311 Jacaranda Dr
Tehachapi, CA 93561-8326
Phone
(661) 265-5032
Fax
(661) 821-2204
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY17461 CA Primary

Addresses

Primary practice location

24311 Jacaranda Dr
Tehachapi, CA 93561-8326

Mailing address

24311 Jacaranda Dr
Tehachapi, CA 93561-8326
Phone (661) 265-5032

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY17461CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295806826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24311 JACARANDA DR",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618326",
            "telephone_number": "661-265-5032",
            "fax_number": "661-821-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24311 JACARANDA DR",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618326",
            "telephone_number": "661-265-5032",
            "fax_number": "661-821-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLEN",
        "first_name": "CAROLE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tehachapi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.