Individual provider Active NPI

Rebecca Dana Raya-Fernandez, PSY.D.

  • Clinical Psychologist
  • Fresno, CA
National Provider Identifier
1376881334
Registry record updated Jan 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY23325 Issued in CA
Practice address
7171 N Millbrook Ave Ste 102
Fresno, CA 93720-3363
Phone
(559) 439-2776
NPI assigned
Jan 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY23325 CA Primary

Addresses

Primary practice location

7171 N Millbrook Ave Ste 102
Fresno, CA 93720-3363

Mailing address

7171 N Millbrook Ave Ste 102
Fresno, CA 93720-3363
Phone (559) 439-2776

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
I20150902000796 CA Practitioner - Clinical Psychologist 7517273758 Practice locations: Fresno, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7171 N Millbrook Ave
Suite 102
Fresno, CA 93720-3363
Phone (559) 439-2776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY23325CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1359158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359158400000",
    "number": "1376881334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 N MILLBROOK AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203363",
            "telephone_number": "559-439-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 N MILLBROOK AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203363",
            "telephone_number": "559-439-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYA-FERNANDEZ",
        "first_name": "REBECCA",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-26",
        "last_updated": "2013-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.