Individual provider Active NPI

Tina Allee, M.D.

  • Psychiatry Physician
  • Costa Mesa, CA
National Provider Identifier
1386960904
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A109503 Issued in CA
Practice address
3151 Airway Ave Ste R
Costa Mesa, CA 92626-4627
Phone
(949) 930-3107
Fax
(949) 930-3107
NPI assigned
Apr 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A109503 CA Primary

Addresses

Primary practice location

3151 Airway Ave Ste R
Costa Mesa, CA 92626-4627

Mailing address

3151 Airway Ave Ste R
Costa Mesa, CA 92626-4627
Phone (949) 930-3107

Other practice location 1

2776 Pacific Ave
C/O Stephanie Blackburn GME office
Long Beach, CA 90806-2613
Phone (949) 288-5377

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 17, 2022 through Jan 17, 2028

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1386960904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE R",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264627",
            "telephone_number": "949-930-3107",
            "fax_number": "949-930-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE R",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264627",
            "telephone_number": "949-930-3107",
            "fax_number": "949-930-3107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2776 Pacific Ave",
            "address_2": "C/O Stephanie Blackburn GME office",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908062613",
            "country_code": "US",
            "telephone_number": "949-288-5377",
            "fax_number": "774-209-4466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEE",
        "first_name": "TINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A109503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.