Ina Creekbaum, EDD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

30705 Issued in CA

Practice address

4181 Flat Rock Dr Ste 300
Riverside, CA 92505-7106

Phone

(909) 856-5904

NPI assigned

Jan 26, 2019

Last updated

Apr 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Illuminating Psychological Services Corporation

  • Counseling Psychologist
  • Riverside, CA
  • NPI 1861090441
  Medicare reassignment Authorized official
• California Healing Horizons

  • Clinic/Center
  • Riverside, CA
  • NPI 1932930120
  NPD Authorized official

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1528522216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 KENDALL DR STE A515",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924074306",
            "telephone_number": "909-856-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 FLAT ROCK DR STE 300",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925057106",
            "telephone_number": "909-856-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEKBAUM",
        "first_name": "INA",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-26",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "30705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Crawford
• Creative Minds Networking
• Creative Options for Postive Education
• Creative Solutions for Kids & Families
• Susan M Creed, CNM
• Amy Crenshaw
• Crescent Healthcare, Inc.
• Crescent Healthcare, Inc. (Crescent Healthcare)
• Jose Ramon Crespo Arangure
• Darlene Crespo Ortega

• Counseling Psychologist in Riverside, CA
• Providers in Riverside, CA by specialty
• Counseling Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.