Organization Active NPI

Center for Integrative Psychology & Wellness Inc

  • Clinical Psychologist
  • Napa, CA
National Provider Identifier
1497059935
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20053 Issued in CA
Legal business name
CENTER FOR INTEGRATIVE PSYCHOLOGY & WELLNESS INC
Practice address
1040 Main St
#305
Napa, CA 94559-2654
Phone
(559) 253-9115
NPI assigned
Dec 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Authorized official

Name
Dr. Lorie T Decarvalho, PH.D., BCETS, FNCCM
Title
Founder and President/Ceo
Phone
(707) 253-9115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY20053 CA Primary

Addresses

Primary practice location

1040 Main St
#305
Napa, CA 94559-2654

Mailing address

PO Box 1932
Hanford, CA 93232-1932

Other identifiers 1

IdentifierTypeStateIssuer
1366480915MedicaidCA

National Provider Directory

National Provider Directory

Locations

1040 Main St
#305
Napa, CA 94559
Phone (559) 253-9115

1040 Main St
Ste 305
Napa, CA 94559
Phone (707) 253-9115

NPI Registry JSON

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

{
    "created_epoch": "1293148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1497059935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1932",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932321932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MAIN ST",
            "address_2": "#305",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945592654",
            "telephone_number": "559-253-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATIVE PSYCHOLOGY & WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-24",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "DECARVALHO",
        "authorized_official_first_name": "LORIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "FOUNDER AND PRESIDENT/CEO",
        "authorized_official_telephone_number": "707-253-9115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., BCETS, FNCCM"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366480915",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.