Individual provider Active NPI

Richard Foss, PH.D.

  • Clinical Psychologist
  • Glendora, CA
National Provider Identifier
1437378536
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20396 Issued in CA
Practice address
150 E Meda Ave
Suite 110
Glendora, CA 91741-2689
Phone
(626) 351-9616
NPI assigned
Apr 25, 2007
Last updated
Jun 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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 PSY20396 CA Primary

Addresses

Primary practice location

150 E Meda Ave
Suite 110
Glendora, CA 91741-2689

Mailing address

150 E Meda Ave
Suite 110
Glendora, CA 91741-2689
Phone (626) 351-9616

Other identifiers 1

IdentifierTypeStateIssuer
PSY 20396OtherCASTATE BOARD OF PSYCHOLOGY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20060301000461 CA Practitioner - Clinical Psychologist 6002822954 Practice locations: Glendora, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 E Meda Ave
Suite 110
Glendora, CA 91741-2607

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY20396CAMDClinical Psychologist
20396CAMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry Professional Services Inc PastSince Jan 12, 2020 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, 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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1437378536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E MEDA AVE",
            "address_2": "SUITE 110",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412689",
            "telephone_number": "626-351-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E MEDA AVE",
            "address_2": "SUITE 110",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412689",
            "telephone_number": "626-351-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSS",
        "first_name": "RICHARD",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PSYCHOLOGY LICENSE",
            "identifier": "PSY 20396",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.