Active NPI
Rachel Fader, PSYD
- Psychologist
- Capitola, CA
National Provider Identifier
1366844151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 4350 Clares St Apt 3
Capitola, CA 95010-2033 - Phone
- (831) 515-8569
- NPI assigned
- Sep 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY31429 | CA | |
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
4350 Clares St Apt 3
Capitola, CA 95010-2033
Mailing address
4350 Clares St Apt 3
Capitola, CA 95010-2033
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY31429 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1366844151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4350 CLARES ST APT 3",
"city": "CAPITOLA",
"state": "CA",
"postal_code": "950102033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 CLARES ST APT 3",
"city": "CAPITOLA",
"state": "CA",
"postal_code": "950102033",
"telephone_number": "831-515-8569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADER",
"first_name": "RACHEL",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-23",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY31429",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Capitola, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.