Individual provider Active NPI

Darra Hirsh, PH.D.

  • Clinical Psychologist
  • Clovis, CA
National Provider Identifier
1386071447
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16504 Issued in CA
Practice address
334 Shaw Ave Ste 100
Clovis, CA 93612
Phone
(559) 712-8500
Fax
(559) 712-8505
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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 PSY16504 CA Primary

Addresses

Primary practice location

334 Shaw Ave Ste 100
Clovis, CA 93612

Mailing address

334 Shaw Ave Ste 100
Clovis, CA 93612-3839
Phone (559) 712-8500

Other practice location 1

23370 Road 22
Chowchilla, CA 93610-8504
Phone (559) 665-5531 ext. 5728

Other practice location 2

23370 Road 22
Chowchilla, CA 93610-8504
Phone (559) 665-5531 ext. 5728

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
I20200207000267 CA Practitioner - Clinical Psychologist 2668808882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A Mind Above a Professional Psychology CorporationGroup PAC ID 1759717978, 5 clinicians

Practice addresses (Care Compare)

1300 E Shaw Ave
Suite 109
Fresno, CA 93710-7903
Phone (559) 712-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16504CAMDClinical Psychologist
16504CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Mind Above, a Professional Psychology Corporation Clinical CurrentSince Aug 12, 2019 Accepting new patients

Locations

334 Shaw Ave
Ste 100
Clovis, CA 93612
Phone (559) 454-1819

1300 E Shaw Ave
Ste 171
Fresno, CA 93710
Phone (559) 313-1398

Organizations & group practices 1

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": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1386071447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 SHAW AVE STE 100",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123839",
            "telephone_number": "559-712-8500",
            "fax_number": "559-712-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 SHAW AVE STE 100",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93612",
            "telephone_number": "559-712-8500",
            "fax_number": "559-712-8505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23370 Road 22",
            "address_purpose": "LOCATION",
            "city": "Chowchilla",
            "state": "CA",
            "postal_code": "936108504",
            "country_code": "US",
            "telephone_number": "559-665-5531 x5728",
            "fax_number": "559-665-6040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23370 Road 22",
            "address_purpose": "LOCATION",
            "city": "Chowchilla",
            "state": "CA",
            "postal_code": "936108504",
            "country_code": "US",
            "telephone_number": "559-665-5531 x5728",
            "fax_number": "559-665-6040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIRSH",
        "first_name": "DARRA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.