Individual provider Active NPI

Sandy Cullins, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1417672684
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33638 Issued in CA
Practice address
409 Camino del Rio S Ste 310
San Diego, CA 92108-3560
Phone
(877) 404-1967
Fax
(619) 810-0383
NPI assigned
Oct 10, 2022
Last updated
Oct 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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 33638 CA Primary

Addresses

Primary practice location

409 Camino del Rio S Ste 310
San Diego, CA 92108-3560

Mailing address

409 Camino del Rio S Ste 310
San Diego, CA 92108-3560
Phone (877) 404-1967

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL scullins@phillipsmedstone.com Direct

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
I20221219002584 CA Practitioner - Clinical Psychologist 6103295829 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33638CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Help Administrative Services Inc Single Specialty CurrentSince Jun 1, 2026 Accepting new patients
Cullins Counseling - a Psychological Corporation Clinical CurrentSince Sep 8, 2023 Accepting new patients
Phillips Medstone a Psychological Corporation Single Specialty CurrentSince Nov 29, 2022 Accepting new patients

Locations

3223 Blume Dr
Richmond, CA 94806

2655 Camino del Rio N
Ste 340
San Diego, CA 92108
Phone (619) 261-8861

3111 Camino del Rio N
Ste 400
San Diego, CA 92108
Phone (858) 244-5176

3636 4th Ave
Ste 304
San Diego, CA 92103
Phone (760) 799-1000

409 Camino del Rio S
Ste 310
San Diego, CA 92108
Phone (877) 404-1967

Organizations & group practices 3

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1417672684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 CAMINO DEL RIO S STE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083560",
            "telephone_number": "877-404-1967",
            "fax_number": "619-810-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 CAMINO DEL RIO S STE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083560",
            "telephone_number": "877-404-1967",
            "fax_number": "619-810-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLINS",
        "first_name": "SANDY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "scullins@phillipsmedstone.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "409 Camino Del Rio S Ste 310",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921083560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.