Active NPI
Michelle Scoggins, PSYD
- Clinical Psychologist
- Clovis, CA
National Provider Identifier
1417318569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 29566
- Practice address
- 2023 N Preuss Ave
Clovis, CA 93619-7464 - Phone
- (559) 246-8679
- NPI assigned
- Mar 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 103T00000X | CA | |
| Clinical Psychologist | 103TC0700X | 29566 | CA | Primary |
Addresses
Primary practice location
2023 N Preuss Ave
Clovis, CA 93619-7464
Mailing address
2023 N Preuss Ave
Clovis, CA 93619-7464
Phone (209) 756-1915
Other practice location 1
338 S Dakota Ave
Vandenberg AFB, CA 93437-6307
Phone (805) 606-8217
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103T00000X | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pasadena Clinical Group, a Psychology Corporation | Clinical | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1417318569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2023 N PREUSS AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936197464",
"telephone_number": "209-756-1915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2023 N PREUSS AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936197464",
"telephone_number": "559-246-8679"
}
],
"practiceLocations": [
{
"address_1": "338 S Dakota Ave",
"address_purpose": "LOCATION",
"city": "Vandenberg AFB",
"state": "CA",
"postal_code": "934376307",
"country_code": "US",
"telephone_number": "805-606-8217",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCOGGINS",
"first_name": "MICHELLE",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-17",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "103T00000X",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "29566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.