Organization Active NPI

Vericare of California Medical Group

  • Clinical Psychologist
  • Paradise, CA
National Provider Identifier
1316992829
Registry record updated Jul 10, 2017
On this page

Key facts

NPPES NPI Registry
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
Last updated
Jul 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2017

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

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SP0808X

Addresses

Primary practice location

1633 Cypress LN
Paradise, CA 95969-2823

Mailing address

55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534
Phone (800) 370-3651

Other names 1

  • Vericare Other name

National Provider Directory

National Provider Directory

Locations (25 of 33)

1130 W La Palma Ave
Anaheim, CA 92801
Phone (714) 772-7480

1665 E Eighth St
Beaumont, CA 92223
Phone (951) 845-3125

9028 Rose St
Bellflower, CA 90706
Phone (562) 925-4252

2223 Ashby Ave
Berkeley, CA 94705
Phone (510) 649-6670

1609 Trousdale Dr
Burlingame, CA 94010
Phone (530) 400-3060

300 Cherry Creek Rd
Cloverdale, CA 95425
Phone (707) 854-5201

504 S El Camino Real
Encinitas, CA 92024
Phone (760) 436-9990

12072 Trask Ave
Garden Grove, CA 92843
Phone (714) 534-1942

900 Sunset Dr
Hollister, CA 95023
Phone (831) 635-1106

911 Sunset Dr
Ste A
Hollister, CA 95023
Phone (831) 635-1111

82262 Valencia Ave
Indio, CA 92201
Phone (760) 347-6000

7855 Ivanhoe Ave
Ste 200
La Jolla, CA 92037
Phone (619) 694-5050

3721 Mt Diablo Blvd
Lafayette, CA 94549
Phone (925) 284-5544

723 E 9th St
Long Beach, CA 90813
Phone (562) 437-2797

1154 S Alvarado St
Los Angeles, CA 90006
Phone (213) 385-1715

230 E Adams Blvd
Los Angeles, CA 90011
Phone (213) 748-0491

3032 Rowena Ave
Los Angeles, CA 90039
Phone (323) 665-1185

1001 Hemlock Ave
Millbrae, CA 94030
Phone (650) 588-1000

6130 Vineland Ave
North Hollywood, CA 91606
Phone (818) 766-8161

460 S Batavia St
Orange, CA 92868
Phone (714) 744-3144

2357S Towne Ave
Pomona, CA 91766
Phone (909) 628-1245

700 E Highland Ave
Redlands, CA 92374
Phone (909) 792-5083

4700 Elvas Ave
Sacramento, CA 95819
Phone (916) 454-4700

2065 Los Gatos Almaden Rd
San Jose, CA 95124
Phone (408) 356-7002

1929 N Fairview St
Santa Ana, CA 92706
Phone (714) 554-9700

Practitioners & affiliated clinicians

Practitioners 89

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 89

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vericare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Paradise, CA

Sources for this page

  • 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.