Individual provider Active NPI

Jose Armando Jorge, PH.D.

  • Clinical Psychologist
  • Fullerton, CA
National Provider Identifier
1477656700
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12951 Issued in CA
Practice address
680 Langsdorf Dr Ste 200
Fullerton, CA 92831-3702
Phone
(714) 871-9264
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 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 PSY12951 CA Primary

Addresses

Primary practice location

680 Langsdorf Dr Ste 200
Fullerton, CA 92831-3702

Mailing address

680 Langsdorf Dr Ste 200
Fullerton, CA 92831-3819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12951CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Child Guidance Center, Inc. Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1477656700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 LANGSDORF DR STE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 LANGSDORF DR STE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313702",
            "telephone_number": "714-871-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGE",
        "first_name": "JOSE",
        "middle_name": "ARMANDO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.