Individual provider Active NPI

Connie McReynolds, PH.D.

  • Clinical Psychologist
  • Redlands, CA
National Provider Identifier
1376606160
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24647 Issued in CA
Practice address
1901 Orange Tree LN Ste 220
Redlands, CA 92374-4582
Phone
(909) 435-7189
Fax
(909) 922-7580
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 24647 CA
Clinical Psychologist 103TC0700X 24647 CA Primary

Addresses

Primary practice location

1901 Orange Tree LN Ste 220
Redlands, CA 92374-4582

Mailing address

1901 Orange Tree LN Ste 220
Redlands, CA 92374-4582
Phone (909) 435-7189

Other practice location 1

8580 Utica Ave # 220
Rancho Cucamonga, CA 91730-4870
Phone (909) 435-7189

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Morningstar Educational & Psychological Services, Inc. Psychologist CurrentSince Oct 22, 2023 Accepting new patients
Health Group Psychological Services, Inc PastSince Dec 15, 2010 Accepting new patients

Locations

1901 Orange Tree Ln
Ste 220
Redlands, CA 92374
Phone (909) 435-7189

Organizations & group practices 2

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1376606160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 ORANGE TREE LN STE 220",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744582",
            "telephone_number": "909-435-7189",
            "fax_number": "909-922-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 ORANGE TREE LN STE 220",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744582",
            "telephone_number": "909-435-7189",
            "fax_number": "909-922-7580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8580 Utica Ave # 220",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917304870",
            "country_code": "US",
            "telephone_number": "909-435-7189",
            "fax_number": "909-922-7580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "24647",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.