Active NPI
Holly Avriette, PHD
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1326152737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 12260
- Practice address
- 11770 Bernardo Plaza CT
Ste 217
San Diego, CA 92128-2422 - Phone
- (858) 484-2713
- Fax
- (858) 487-4741
- NPI assigned
- Aug 19, 2006
- Last updated
- Jul 16, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 12260 | CA | Primary |
Addresses
Primary practice location
11770 Bernardo Plaza CT
Ste 217
San Diego, CA 92128-2422
Mailing address
PO Box 28824
San Diego, CA 92198-0824
Phone (858) 487-2713
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY 12260 | Other | CA | PHD |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 12260 | CA | MD | Clinical Psychologist |
| 12260 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1326152737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 28824",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921980824",
"telephone_number": "858-487-2713",
"fax_number": "858-487-4741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11770 BERNARDO PLAZA CT",
"address_2": "STE 217",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282422",
"telephone_number": "858-484-2713",
"fax_number": "858-487-4741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVRIETTE",
"first_name": "HOLLY",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 12260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHD",
"identifier": "PSY 12260",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.