Active NPI
Timothy Mark Beach, PSY. D.
- Clinical Psychologist
- Merced, CA
National Provider Identifier
1427397702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 22544
- Practice address
- 414 W 21St St
Merced, CA 95340-3718 - Phone
- (510) 502-3163
- NPI assigned
- Feb 6, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 22544 | CA | Primary |
Addresses
Primary practice location
414 W 21St St
Merced, CA 95340-3718
Mailing address
414 W 21St St
Merced, CA 95340-3718
Phone (510) 502-3163
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 12, 2024 through Apr 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22544 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Department of Corrections &Rehabilitation | Past | Accepting new patients | |
| State of California | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rural Health Clinic/Center
- Chowchilla, CA
- NPI 1073710398
-
- Prison Health Clinic/Center
- Chowchilla, CA
- NPI 1316322647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1427397702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 W 21ST ST",
"city": "MERCED",
"state": "CA",
"postal_code": "953403718",
"telephone_number": "510-502-3163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 W 21ST ST",
"city": "MERCED",
"state": "CA",
"postal_code": "953403718",
"telephone_number": "510-502-3163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEACH",
"first_name": "TIMOTHY",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "PSY. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-06",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "22544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merced, CA
- Bay Area Spine Care
- David Bayoh
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- Baz Allergy, Asthma & Sinus Center, Inc.
- Kathryn Louise Beach, OTR/L
- Bear Creek Anesthesia Medical Group
- Bear Creek Family Dental
- Naseem Neon Beauchman, M.D.
- Ma Mildred Bebero, FNP
- Julia Angelica Quezada Becerra, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.