Active NPI
Andrea Nelson, PSY.D.
- Clinical Psychologist
- Ojai, CA
National Provider Identifier
1386662369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY13378
- Practice address
- 530 W Ojai Ave
Suite 206
Ojai, CA 93023-2472 - Phone
- (805) 640-8549
- Fax
- (805) 640-8624
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY13378 | CA | Primary |
Addresses
Primary practice location
530 W Ojai Ave
Suite 206
Ojai, CA 93023-2472
Mailing address
530 W Ojai Ave
Suite 206
Ojai, CA 93023-2472
Phone (805) 640-8549
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00CP13378 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY13378 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207526400000",
"number": "1386662369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 W OJAI AVE",
"address_2": "SUITE 206",
"city": "OJAI",
"state": "CA",
"postal_code": "930232472",
"telephone_number": "805-640-8549",
"fax_number": "805-640-8624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 W OJAI AVE",
"address_2": "SUITE 206",
"city": "OJAI",
"state": "CA",
"postal_code": "930232472",
"telephone_number": "805-640-8549",
"fax_number": "805-640-8624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "ANDREA",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2008-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY13378",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00CP13378",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ojai, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.