Active NPI
Michele Marie Ernst, PSY.D.
- Clinical Psychologist
- Woodland, CA
National Provider Identifier
1508031923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY18854
- Practice address
- 34150 Canvas Back St
Woodland, CA 95695-6018 - Phone
- (530) 661-9036
- NPI assigned
- Apr 26, 2008
- Sex
- Female
- 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 | PSY18854 | CA | Primary |
Addresses
Primary practice location
34150 Canvas Back St
Woodland, CA 95695-6018
Mailing address
PO Box 2305
Davis, CA 95617-2305
Phone (530) 661-9036
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18854 | CA | MD | Clinical Psychologist |
| 430 | ND | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209168000000",
"number": "1508031923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2305",
"city": "DAVIS",
"state": "CA",
"postal_code": "956172305",
"telephone_number": "530-661-9036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34150 CANVAS BACK ST",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956956018",
"telephone_number": "530-661-9036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERNST",
"first_name": "MICHELE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-26",
"last_updated": "2008-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.