Individual provider Active NPI

Carmelina Mule, PSY. D

  • Clinical Psychologist
  • Fair Oaks, CA
National Provider Identifier
1487718342
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20786 Issued in CA
Practice address
4540 Crest Rd
Fair Oaks, CA 95628-6129
Phone
(916) 792-8137
Fax
(916) 536-9413
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 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 20786 CA Primary

Addresses

Primary practice location

4540 Crest Rd
Fair Oaks, CA 95628-6129

Mailing address

4540 Crest Rd
Fair Oaks, CA 95628-6129
Phone (916) 792-8137

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
I20120522000768 CA Practitioner - Clinical Psychologist 9335302777 Practice locations: Fair Oaks, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4092 Bridge St
Fair Oaks, CA 95628-7133
Phone (916) 792-8137

4540 Crest Rd
Fair Oaks, CA 95628-6129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1487718342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 CREST RD",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286129",
            "telephone_number": "916-792-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 CREST RD",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286129",
            "telephone_number": "916-792-8137",
            "fax_number": "916-536-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULE",
        "first_name": "CARMELINA",
        "credential": "PSY. D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "20786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

Verify at the official NPI Registry.