NPIMap

Organization Active NPI

Center for Neuropsychology, a Psychological Corporation

  • Clinical Neuropsychologist
  • Redding, CA
National Provider Identifier
1477090488
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY26823 Issued in CA
Legal business name
CENTER FOR NEUROPSYCHOLOGY, A PSYCHOLOGICAL CORPORATION
Practice address
2628 Victor Ave Ste B
Redding, CA 96002-1454
Phone
(530) 710-1070
NPI assigned
Jan 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tammy Grabreck, PHDNPI 1922411396
Title
President
Phone
(530) 710-1070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X PSY26823 CA Primary

Addresses

Primary practice location

2628 Victor Ave Ste B
Redding, CA 96002-1454

Mailing address

2628 Victor Ave Ste B
Redding, CA 96002-1454
Phone (530) 710-1070

Other names 1

  • Center For Neuropsychology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170427002300 CA Part B Supplier - Clinic/Group Practice 4183901234 Receives reassigned benefits from 1 practitioner
Practice locations: Redding, CA

National Provider Directory

National Provider Directory

Locations

2628 Victor Ave
Ste B
Redding, CA 96002
Phone (530) 710-1070

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1477090488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 VICTOR AVE STE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021454",
            "telephone_number": "530-710-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 VICTOR AVE STE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021454",
            "telephone_number": "530-710-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR NEUROPSYCHOLOGY, A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-28",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "GRABRECK",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-710-1070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY26823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center For Neuropsychology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center For Neuropsychology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.