Carol Rose Michelson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY9297 Issued in CA

Practice address

219 N Indian Hill Blvd
Suite 103
Claremont, CA 91711-4644

Phone

(909) 621-1652

NPI assigned

Feb 15, 2007

Last updated

Jul 8, 2007By 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, 1984

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

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558404996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N INDIAN HILL BLVD",
            "address_2": "SUITE 103",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114644",
            "telephone_number": "909-621-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N INDIAN HILL BLVD",
            "address_2": "SUITE 103",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114644",
            "telephone_number": "909-621-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSON",
        "first_name": "CAROL",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Merrigan
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• MH Claremont Operating, LLC (Claremont Place Senior Living)
• Michael a Sequeira MD Inc
• Jeanette Marie Michel
• Stephanie Minami, RDN
• Lourdes Minaya, MD
• Mindwell, a Licensed Marriage and Family Therapy Corporation
• Maria Jamil-Qureshi Mir, CL MFT
• Glenn Yukio Miya, MD

• Clinical Psychologist in Claremont, CA
• Providers in Claremont, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.