Active NPI
Raymond L. Hansink, PHD
- Clinical Psychologist
- San Juan Capistrano, CA
National Provider Identifier
1497708762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY16087
- Practice address
- 29222 Rancho Viejo Rd
Suite 208
San Juan Capistrano, CA 92675-1041 - Phone
- (949) 933-3556
- Fax
- (949) 481-1149
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY16087 | CA | Primary |
Addresses
Primary practice location
29222 Rancho Viejo Rd
Suite 208
San Juan Capistrano, CA 92675-1041
Mailing address
29222 Rancho Viejo Rd
Suite 208
San Juan Capistrano, CA 92675-1045
Phone (949) 933-3556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY160870 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110406000631 | CA | Practitioner - Psychologist Billing Independently | 2062598899 | Practice locations: Laguna Niguel, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
Laguna Niguel, CA 92677
Phone (949) 933-3556
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16087 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1497708762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29222 RANCHO VIEJO RD",
"address_2": "SUITE 208",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926751045",
"telephone_number": "949-933-3556",
"fax_number": "949-481-1149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29222 RANCHO VIEJO RD",
"address_2": "SUITE 208",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926751041",
"telephone_number": "949-933-3556",
"fax_number": "949-481-1149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSINK",
"first_name": "RAYMOND",
"middle_name": "L.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY16087",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY160870",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan Capistrano, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.