Individual provider Active NPI

Antoine Francisco, PH.D.

  • Clinical Psychologist
  • Costa Mesa, CA
National Provider Identifier
1356565766
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY6247 Issued in CA
Practice address
250 Fischer Ave
Costa Mesa, CA 92626-4515
Phone
(949) 836-8522
Fax
(949) 644-5371
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY6247 CA Primary

Addresses

Primary practice location

250 Fischer Ave
Costa Mesa, CA 92626-4515

Mailing address

250 Fischer Ave
Costa Mesa, CA 92626-4515
Phone (949) 836-8522

Other identifiers 1

IdentifierTypeStateIssuer
PSY6247OtherCALIFORNIA

Other names 1

  • Anthony Francisco Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200306002321 CA Practitioner - Clinical Psychologist 0749618676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY6247CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
California Physicians Medical Group, Inc. 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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1356565766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 FISCHER AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264515",
            "telephone_number": "949-836-8522",
            "fax_number": "949-644-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 FISCHER AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264515",
            "telephone_number": "949-836-8522",
            "fax_number": "949-644-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCISCO",
        "first_name": "ANTOINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY6247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA",
            "identifier": "PSY6247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "FRANCISCO",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.