Individual provider Active NPI

Thom Frank Cavalli

  • Psychologist
  • Santa Ana, CA
National Provider Identifier
1497768089
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY7180 Issued in CA
Practice address
540 N Golden Circle Drive
Suite 114
Santa Ana, CA 92705-3914
Phone
(714) 731-3238
Fax
(714) 558-2644
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY7180 CA Primary

Addresses

Primary practice location

540 N Golden Circle Drive
Suite 114
Santa Ana, CA 92705-3914

Mailing address

1422 Cameo Dr
Tustin, CA 92780-3505
Phone (714) 832-9426

Other names 1

  • Dr. Thomas Frank Cavalli Other name

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
I20101207001125 CA Practitioner - Clinical Psychologist 4789871492 Practice locations: Santa Ana, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2030 E 4TH St
Santa Ana, CA 92705-3922
Phone (714) 972-0056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY7180CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497768089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 CAMEO DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803505",
            "telephone_number": "714-832-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N GOLDEN CIRCLE DRIVE",
            "address_2": "SUITE 114",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053914",
            "telephone_number": "714-731-3238",
            "fax_number": "714-558-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLI",
        "first_name": "THOM",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY7180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "CAVALLI",
            "middle_name": "FRANK",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.