Organization Active NPI

Tory D. Pepper, PH.D., a Professional Psychology Corporation

  • Psychologist
  • San Diego, CA
National Provider Identifier
1528505237
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY18383 Issued in CA
Legal business name
TORY D. PEPPER, PH.D., A PROFESSIONAL PSYCHOLOGY CORPORATION
Practice address
9683 Tierra Grande St
105
San Diego, CA 92126-6503
Phone
(858) 695-2237
Fax
(858) 695-2238
NPI assigned
Jan 20, 2017
Last updated
Jan 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Dr. Tory Deborah Pepper, PH.D.NPI 1801807581
Title
Licensed Clinical Psychologist
Phone
(858) 695-2237

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY18383 CA Primary

Addresses

Primary practice location

9683 Tierra Grande St
105
San Diego, CA 92126-6503

Mailing address

9683 Tierra Grande St
105
San Diego, CA 92126-6503
Phone (858) 695-2237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170227002119 CA Part B Supplier - Clinic/Group Practice 4587948187 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

9845 Erma Rd
Ste 210
San Diego, CA 92131
Phone (619) 789-4880

9845 Erma Rd
Ste 210P
San Diego, CA 92131
Phone (619) 789-4880

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1528505237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9683 TIERRA GRANDE ST",
            "address_2": "105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921266503",
            "telephone_number": "858-695-2237",
            "fax_number": "858-695-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9683 TIERRA GRANDE ST",
            "address_2": "105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921266503",
            "telephone_number": "858-695-2237",
            "fax_number": "858-695-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TORY D. PEPPER, PH.D., A PROFESSIONAL PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "PEPPER",
        "authorized_official_first_name": "TORY",
        "authorized_official_middle_name": "DEBORAH",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "858-695-2237",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY18383",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.