Gina M Bettica, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9161 Issued in FL

Practice address

1881 N University Dr
Suite 104
Coral Springs, FL 33071-8915

Phone

(954) 340-0888

Fax

(954) 346-0909

NPI assigned

Feb 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1568601466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 N UNIVERSITY DR",
            "address_2": "SUITE 104",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718915",
            "telephone_number": "954-340-0888",
            "fax_number": "954-346-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 N UNIVERSITY DR",
            "address_2": "SUITE 104",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718915",
            "telephone_number": "954-340-0888",
            "fax_number": "954-346-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTICA",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "WA",
            "license": "PY00003775",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.