Individual provider Active NPI

Christopher W Ingalls, PHD

  • Clinical Psychologist
  • Newport Beach, CA
National Provider Identifier
1497862619
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10123 Issued in CA
Practice address
1001 Dove St
Suite 140
Newport Beach, CA 92660
Phone
(949) 722-7441
Fax
(949) 261-1183
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

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
Clinical Psychologist 103TC0700X PSY10123 CA Primary

Addresses

Primary practice location

1001 Dove St
Suite 140
Newport Beach, CA 92660

Mailing address

PO Box 10758
Costa Mesa, CA 92627
Phone (949) 722-7441

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
I20100504000766 CA Practitioner - Clinical Psychologist 5395873830 Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 Dove St
Suite 140
Newport Beach, CA 92660-2846
Phone (949) 757-9863

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY10123CAMDClinical Psychologist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497862619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10758",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "949-722-7441",
            "fax_number": "949-261-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 DOVE ST",
            "address_2": "SUITE 140",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-722-7441",
            "fax_number": "949-261-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGALLS",
        "first_name": "CHRISTOPHER",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY10123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.