Supportive Psychological Care

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

PSY13748 Issued in CA

Legal business name

SUPPORTIVE PSYCHOLOGICAL CARE

Practice address

9267 Greenback LN
B98
Orangevale, CA 95662-4863

Phone

(916) 505-9151

Fax

(916) 988-7864

NPI assigned

Dec 3, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Cyrus Moazam, PHD

Title

Owner

Phone

(916) 505-9151

Specialties & licenses 1

Addresses

Other names 1

• N/A Other name

Locations

Practitioners 1

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

• Ernest Jarman III, PH.D.

  • Clinical Psychologist
  • Orangevale, CA
  • NPI 1063669307
  NPD (past)

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1366787269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9267 GREENBACK LN",
            "address_2": "B-98",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956624863",
            "telephone_number": "916-505-9151",
            "fax_number": "916-988-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9267 GREENBACK LN",
            "address_2": "B98",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956624863",
            "telephone_number": "916-505-9151",
            "fax_number": "916-988-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE PSYCHOLOGICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "MOAZAM",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-505-9151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "PSY13748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gregory Scott Spittler, RADT # R1497990223
• Casandra Elaine Steele
• Florentine Stefanescu, L.AC., DIPL. AC.
• Mabel Strasser-King
• Summerville at Hazel Creek LLC
• Sweet Guardians Home Health
• Bonnie Jean Swift
• Edward Daniel Talya, M.D.
• Nadien Kauthar Tayeh, RBT
• Amanda Thao

• Adult Mental Health Clinic/Center in Orangevale, CA
• Providers in Orangevale, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.