Individual provider Active NPI

Chalita Shanae Antommarchi

  • Psychologist
  • Claremont, CA
National Provider Identifier
1407433428
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
101 N Indian Hill Blvd Ste C2-202
Claremont, CA 91711-4670
Phone
(909) 521-8651
NPI assigned
Mar 25, 2021
Last updated
Mar 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

101 N Indian Hill Blvd Ste C2-202
Claremont, CA 91711-4670

Mailing address

24898 Sanitarium Dr Lindsay Hall Box 106
Loma Linda, CA 92350-0001
Phone (703) 401-3961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsmith Psychology, Inc CurrentSince Mar 28, 2021 Accepting new patients

Locations

101 N Indian Hill Blvd
Ste C2-202
Claremont, CA 91711
Phone (909) 521-8651

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1407433428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24898 SANITARIUM DR LINDSAY HALL BOX 106",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "703-401-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N INDIAN HILL BLVD STE C2-202",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114670",
            "telephone_number": "909-521-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOMMARCHI",
        "first_name": "CHALITA",
        "middle_name": "SHANAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.