Vericare of California Medical Group

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

VERICARE OF CALIFORNIA MEDICAL GROUP

Practice address

1633 Cypress LN
Paradise, CA 95969-2823

Phone

(800) 257-8715

Fax

(800) 819-1655

NPI assigned

May 23, 2006

Reactivated

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Melissa King

Title

Director, Credentialing Enrollment

Phone

(800) 370-3651

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Vericare Other name

Locations (25 of 39)

Practitioners 88

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

• Dale Anne Alexander, PHD, LP

  • Clinical Psychologist
  • Pasadena, CA
  • NPI 1477714095

  Clinical

  NPD (past)
• Charles Perry Allen, PHD

  • Clinical Psychologist
  • Camarillo, CA
  • NPI 1568512127

  Clinical

  NPD (past)
• Maritza Baez Alvarez, PSY.D.

  • Clinical Psychologist
  • Buena Park, CA
  • NPI 1124269246

  Clinical

  NPD (past)
• Pardis Amirhoushmand, PH.D.

  • Psychologist
  • Ontario, CA
  • NPI 1003946179
  NPD (past)
• Edgar O. Angelone, PH.D

  • Clinical Neuropsychologist
  • San Rafael, CA
  • NPI 1407919988
  NPD (past)
• Maria T. Arieta, PSY.D.

  • Clinical Psychologist
  • San Rafael, CA
  • NPI 1487784617

  Clinical

  NPD (past)
• Sheilly Arora

  • Clinical Psychologist
  • West Covina, CA
  • NPI 1770654949

  Clinical

  NPD (past)
• Crystal Ann Barile, PH.D.

  • Psychologist
  • Tustin, CA
  • NPI 1407804818
  NPD (past)
• Catherine Finney Barker, PH.D.

  • Clinical Psychologist
  • Pasadena, CA
  • NPI 1376774943

  Clinical

  NPD (past)
• Alisha Christine Bent, PH.D.

  • Clinical Psychologist
  • Norwalk, CA
  • NPI 1134365943

  Clinical

  NPD (past)
• Steven Bryan Blakely

  • Clinical Psychologist
  • Thousand Oaks, CA
  • NPI 1780765909

  Clinical

  NPD (past)
• Dianne E. Bohorquez, PH.D.

  • Clinical Psychologist
  • San Pedro, CA
  • NPI 1467617142

  Clinical

  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499644800000",
    "number": "1316992829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 CYPRESS LN",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959692823",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERICARE OF CALIFORNIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-07-10",
        "deactivation_date": "2007-04-11",
        "reactivation_date": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING ENROLLMENT",
        "authorized_official_telephone_number": "800-370-3651"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC7816",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPS000150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vericare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mica Vang
• Penny Vang
• Jake Bubba Vasquez
• Andre Augusto Venturini
• Amber Haley Vereecke
• Paul James Vesely, RPH
• Mary Susan Waldemar, R.N.
• Walgreen Co
• Stephen Richard Walters
• Rachel Mae Walton

• All providers in Paradise, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.