John Thomas Harlow Engelhardt, PSY.D.
Individual provider Active NPI Clinical Psychologist · Redlands, CA
NPI 1376524645 · NPPES record last updated Jan 28, 2020
Key facts
- NPI
- 1376524645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 31436 (CA)
- Practice address
- 330 6TH St Ste 110
Redlands, CA 92374-3312 - Phone
- (909) 307-1204
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31436 | CA | MD | Clinical Psychologist |
| 1390 | OR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Act Family Counseling Incorporated | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 31436 | CA | Yes |
| Clinical Psychologist | 103TC0700X | 1390 | OR |
Addresses
Primary practice location
330 6TH St Ste 110
Redlands, CA 92374-3312
Mailing address
6841 Ranchgrove Rd
Riverside, CA 92506-5307
Phone (503) 330-7850
Other practice location 1
2315 Villa Rd
Newberg, OR 97132-9576
Phone (503) 330-7850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1390 | Other | OR | LICENSE NUMBER (PSYCHOLOG |
| 31436 | Other | CA | LICENSE NUMBER |
Other providers in Redlands, CA
- Kelleigh Ellison
- Peter Elsissy
- Bethany Skye Elton
- Emad Ibrahim, MD, Inc.
- Emelly Rosspencer Licensed Marriage & Family Therapist Inc
- Erin K Engstrom
- Josue Daniel Enriquez Quezada
- Aimee Marie Enriquez
- Danielle Alexis Enriquez
- Lauren A Enriquez
All providers in Redlands, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.