Active NPI
Clary Tepper, PH.D.
- Psychologist
- Sacramento, CA
National Provider Identifier
1417249269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY19115
- Practice address
- 2509 Capitol Avenue
Sacramento, CA 95816 - Phone
- (916) 607-2299
- NPI assigned
- May 12, 2011
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY19115 | CA | Primary |
Addresses
Primary practice location
2509 Capitol Avenue
Sacramento, CA 95816
Mailing address
2509 Capitol Avenue
Sacramento, CA 95816
Phone (916) 607-2299
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: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305158400000",
"number": "1417249269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2509 CAPITOL AVENUE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95816",
"telephone_number": "916-607-2299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2509 CAPITOL AVENUE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95816",
"telephone_number": "916-607-2299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEPPER",
"first_name": "CLARY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-12",
"last_updated": "2011-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY19115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.