Callista Frye, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29061 Issued in CA

Practice address

5905 Lake Earl Dr
Crescent City, CA 95532-5353

Phone

(707) 465-1000

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1306032982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 LAKE EARL DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955320001",
            "telephone_number": "805-704-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 LAKE EARL DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955325353",
            "telephone_number": "707-465-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "CALLISTA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "T-LP 2099",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "B7715996",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Ellsworth Farr, P.T.
• Jennifer Lee Feliciano
• Kiley Marie Ferreira
• Debra Courtney Foster, MSW
• Cindy J Fox, L.C.S.W.
• Wendy Fullerton
• Richard Fulroth, MD
• Function Junction Rehabilitation Center
• Cynthia Marie Gage
• Debra Gaines, RN

• Clinical Psychologist in Crescent City, CA
• Providers in Crescent City, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.