Active NPI
Aundrea Michelle Paxton, PSYD
- Clinical Psychologist
- Costa Mesa, CA
National Provider Identifier
1316379704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3457
- Practice address
- 1550 Superior Ave
Costa Mesa, CA 92627-3778 - Phone
- (949) 270-2100
- Fax
- (949) 650-4458
- NPI assigned
- Aug 7, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 29708 | CA | |
| Clinical Psychologist | 103TC0700X | 3457 | OR | Primary |
Addresses
Primary practice location
1550 Superior Ave
Costa Mesa, CA 92627-3778
Mailing address
14845 SW Murray Scholls Dr.
Ste 110 PMB 219
Beaverton, OR 97007-9237
Phone (562) 334-2246
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://aundrea-paxton.clientsecure.me/ | Health Information Exchange (HIE) |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29708 | CA | MD | Endodontist |
Interoperability endpoints
- aundrea.paxton.1@17650.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650412800000",
"number": "1316379704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14845 SW MURRAY SCHOLLS DR.",
"address_2": "STE 110 PMB 219",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970079237",
"telephone_number": "562-334-2246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 SUPERIOR AVE",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273778",
"telephone_number": "949-270-2100",
"fax_number": "949-650-4458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAXTON",
"first_name": "AUNDREA",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-07",
"last_updated": "2022-04-20",
"certification_date": "2022-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "29708",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "3457",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://aundrea-paxton.clientsecure.me/",
"affiliation": "N",
"endpointDescription": "Simple Practice Client Portal",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "EHR",
"address_1": "14845 SW Murray Scholls Dr",
"address_2": "Ste 110 PMB 219",
"city": "Beaverton",
"state": "OR",
"country_code": "US",
"postal_code": "97007",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.