J Roland Fleck, EDD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 5502 Issued in CA

Practice address

4405 Manchester Ave
Suite 103
Encinitas, CA 92024-4940

Phone

(760) 942-1210

Fax

(760) 942-3965

NPI assigned

Mar 10, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• J Roland Fleck

  • Clinical Psychologist
  • Encinitas, CA
  • NPI 1770764847
  NPD (past) Authorized official

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1497925093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244940",
            "telephone_number": "760-942-1210",
            "fax_number": "760-942-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244940",
            "telephone_number": "760-942-1210",
            "fax_number": "760-942-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLECK",
        "first_name": "J",
        "middle_name": "ROLAND",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY 5502",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 5502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Jean Fitzpatrick, CRNA
• Travis John Fitzpatrick, CRNA
• Chantal Flanagan, PMHNP-BC
• Kathleen M Flanigan, LCSW
• Tamara Fleck-Myers
• Taylor Jo Florence, DMD
• Flowintegrative PC
• Adam D Fogelman, D.C.
• Mallorie Joy Foley
• Nicole Maria Folmer, LMFT

• Clinical Psychologist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.