Active NPI
Randy Payne
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1508394388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 9465 Farnham St
San Diego, CA 92123-1308 - Phone
- (909) 433-0445
- NPI assigned
- May 24, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
9465 Farnham St
San Diego, CA 92123-1308
Mailing address
790 Via Lata Ste 300
Colton, CA 92324-3978
Phone (909) 433-0445
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730224031 | Other | CA | 01 |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495584000000",
"number": "1508394388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 VIA LATA STE 300",
"city": "COLTON",
"state": "CA",
"postal_code": "923243978",
"telephone_number": "909-433-0445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9465 FARNHAM ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231308",
"telephone_number": "909-433-0445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "RANDY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-24",
"last_updated": "2017-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "01",
"identifier": "1730224031",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.