Individual provider Active NPI

Judy Fluor Runels, PSYD

  • Clinical Psychologist
  • Huntington Beach, CA
National Provider Identifier
1396787156
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20804 Issued in CA
Practice address
17822 Beach Blvd.
Suite 230
Huntington Beach, CA 92647
Phone
(714) 284-7573
Fax
(714) 842-8330
NPI assigned
Jun 12, 2006
Last updated
Jan 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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 20804 CA Primary

Addresses

Primary practice location

17822 Beach Blvd.
Suite 230
Huntington Beach, CA 92647

Mailing address

17822 Beach Blvd.
Suite 230
Huntington Beach, CA 92647
Phone (714) 284-7573

Other identifiers 1

IdentifierTypeStateIssuer
WCP20804AOtherCAMAC

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
I20061103000496 CA Practitioner - Clinical Psychologist 7113924168 Practice locations: Huntington Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17822 Beach Blvd
Suite 230
Huntington Beach, CA 92647-7192
Phone (714) 284-7573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bien Physical Therapy, Inc Past Accepting new patients
Pathways to Wellness Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1396787156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD.",
            "address_2": "SUITE 230",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92647",
            "telephone_number": "714-284-7573",
            "fax_number": "714-842-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD.",
            "address_2": "SUITE 230",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92647",
            "telephone_number": "714-284-7573",
            "fax_number": "714-842-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNELS",
        "first_name": "JUDY",
        "middle_name": "FLUOR",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "20804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAC",
            "identifier": "WCP20804A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.