Active NPI
Corie Diane Houlbjerg, PSY.D.
- Psychologist
- Redlands, CA
National Provider Identifier
1518209386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 26001 Redlands Blvd
Redlands, CA 92373-7762 - Phone
- (909) 825-7084
- NPI assigned
- Mar 20, 2013
- Last updated
- Jun 19, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary | ||
| Health Psychologist | 103TH0004X |
Addresses
Primary practice location
26001 Redlands Blvd
Redlands, CA 92373-7762
Mailing address
26001 Redlands Blvd
Redlands, CA 92374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 20, 2020 through Feb 20, 2028
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": "1363737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1518209386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26001 REDLANDS BLVD",
"city": "REDLANDS",
"state": "CA",
"postal_code": "92374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26001 REDLANDS BLVD",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923737762",
"telephone_number": "909-825-7084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOULBJERG",
"first_name": "CORIE",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-20",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.