Active NPI
Raymond Vagas, PH.D.
- Clinical Psychologist
- Costa Mesa, CA
National Provider Identifier
1316330459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 13311
- Practice address
- 2501 Harbor Blvd
Costa Mesa, CA 92626-6143 - Phone
- (949) 350-4460
- NPI assigned
- Mar 13, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-12-11590 | CA | |
| Clinical Psychologist | 103TC0700X | PSY 13311 | CA | Primary |
Addresses
Primary practice location
2501 Harbor Blvd
Costa Mesa, CA 92626-6143
Mailing address
31878 Del Obispo St
#118 Pmb486
San Juan Capistrano, CA 92675-3223
Phone (949) 350-4460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160229002902 | CA | Practitioner - Clinical Psychologist | 7810292885 | Practice locations: San Juan Capo, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
27881 Via Estancia
San Juan Capistrano, CA 92675-3835
Phone (949) 350-4460
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 13311 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426204800000",
"number": "1316330459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31878 DEL OBISPO ST",
"address_2": "#118 PMB486",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926753223",
"telephone_number": "949-350-4460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 HARBOR BLVD",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926266143",
"telephone_number": "949-350-4460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAGAS",
"first_name": "RAYMOND",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-13",
"last_updated": "2015-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-12-11590",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 13311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.