Individual provider Active NPI

Cynthia M Thorp, PSY.D.

  • Clinical Psychologist
  • Roseville, CA
National Provider Identifier
1396877346
Registry record updated Feb 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 23951 Issued in CA
Practice address
300 Harding Blvd
Suite 112C
Roseville, CA 95678-2470
Phone
(916) 764-0915
NPI assigned
Mar 12, 2007
Last updated
Feb 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2011

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 PSY 23951 CA Primary

Addresses

Primary practice location

300 Harding Blvd
Suite 112C
Roseville, CA 95678-2470

Mailing address

PO Box 865
Rocklin, CA 95677-0865
Phone (916) 764-0915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20131206000364 NV Practitioner - Clinical Psychologist 1759566144 Practice locations: Gardnerville, NV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1462 US Hwy 395 N
Gardnerville, NV 89410-5203
Phone (775) 790-7771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23951CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Margaret Dixon LC Psychologist PastSince Jan 31, 2021 Accepting new patients

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, 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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298678400000",
    "number": "1396877346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 865",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956770865",
            "telephone_number": "916-764-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HARDING BLVD",
            "address_2": "SUITE 112C",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782470",
            "telephone_number": "916-764-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORP",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2011-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 23951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.