Active NPI
Regina M Granados, PSYD
- Psychologist
- Folsom, CA
National Provider Identifier
1508005646
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 20, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 21246
- Practice address
- 1002 River Rock Dr
Suite 221
Folsom, CA 95630-2094 - Phone
- (916) 605-8654
- Fax
- (916) 358-8488
- NPI assigned
- Feb 12, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 21246 | CA | Primary |
Addresses
Primary practice location
1002 River Rock Dr
Suite 221
Folsom, CA 95630-2094
Mailing address
1002 River Rock Dr
Suite 221
Folsom, CA 95630-2094
Phone (916) 605-8654
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 21246 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280361600000",
"number": "1508005646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 RIVER ROCK DR",
"address_2": "SUITE 221",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302094",
"telephone_number": "916-605-8654",
"fax_number": "916-358-8488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 RIVER ROCK DR",
"address_2": "SUITE 221",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302094",
"telephone_number": "916-605-8654",
"fax_number": "916-358-8488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANADOS",
"first_name": "REGINA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-12",
"last_updated": "2010-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 21246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Folsom, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.