Active NPI
Simone Ravicz, PH.D.
- Psychologist
- Palm Springs, CA
National Provider Identifier
1437714540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY15512
- Practice address
- 565 S la Mirada Rd
Palm Springs, CA 92264-7314 - Phone
- (760) 904-7957
- NPI assigned
- May 3, 2019
- 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 | PSY15512 | CA | Primary |
Addresses
Primary practice location
565 S la Mirada Rd
Palm Springs, CA 92264-7314
Mailing address
565 S la Mirada Rd
Palm Springs, CA 92264
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 31, 2024 through May 31, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15512 | CA | MD | Psychologist |
| 15512 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1437714540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "565 S LA MIRADA RD",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "92264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 S LA MIRADA RD",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922647314",
"telephone_number": "760-904-7957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVICZ",
"first_name": "SIMONE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-03",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY15512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.