Individual provider Active NPI

Ryan Casey Aguinaldo, PSYD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1356036552
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34057 Issued in CA
Practice address
9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411
Phone
(800) 270-5016
NPI assigned
Apr 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY34057 CA Primary

Addresses

Primary practice location

9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411

Mailing address

9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY34057CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Institutes of Health Behavioral Medicine and Medical Psychology Inc. Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1356036552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9246 LIGHTWAVE AVE STE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921236411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9246 LIGHTWAVE AVE STE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921236411",
            "telephone_number": "800-270-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUINALDO",
        "first_name": "RYAN",
        "middle_name": "CASEY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34057",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 5, 2023; 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.