Individual provider Active NPI

Maria Sadeghi, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1457418592
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-18302 Issued in CA
Practice address
11417 W Bernardo CT
Ste K
San Diego, CA 92127-1639
Phone
(858) 254-4192
NPI assigned
Jan 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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 PSY-18302 CA Primary

Addresses

Primary practice location

11417 W Bernardo CT
Ste K
San Diego, CA 92127-1639

Mailing address

414 Vista Heights Rd
El Cerrito, CA 94530-6506
Phone (510) 412-0902

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
I20170623000095 CA Practitioner - Clinical Psychologist 4082982129 Practice locations: Temecula, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Temecula, CA 92592
Phone (858) 254-0071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY-18302CAMDClinical Psychologist
18302CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1457418592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 VISTA HEIGHTS RD",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945306506",
            "telephone_number": "510-412-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11417 W BERNARDO CT",
            "address_2": "STE K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271639",
            "telephone_number": "858-254-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADEGHI",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY-18302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.