Carrie Profitt, PHD, HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041923 Issued in IN

Practice address

10333 El Camino Real
Atascadero, CA 93422-5808

Phone

(805) 468-2000

Fax

(805) 468-6011

NPI assigned

Jul 2, 2006

Last updated

Jul 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Indiana University Health, Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1376586719

  Clinical

  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1578592341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET, ROOM 150",
            "address_2": "FISCAL ALLOCATIONS AND ESTIMATES UNIT",
            "city": "SACRAMENTO",
            "state": "IN",
            "postal_code": "958146414",
            "telephone_number": "916-651-9475",
            "fax_number": "916-651-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225808",
            "telephone_number": "805-468-2000",
            "fax_number": "805-468-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFITT",
        "first_name": "CARRIE",
        "name_prefix": "Dr.",
        "credential": "PHD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200506080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bella Prestoza, M.D
• Elizabeth Dougherty Price, M.A. CCC-SLP
• Katherine E Price
• Primary Eyecare Center an Optometric Practice
• Michael Francis Pritchard, PHD
• Gabriela Araceli Puga-Arevalo
• David Pyo, PH.D.
• Leticia Quezada
• Veronica Ruth Quezada, MD
• Ashley Quigley

• Clinical Psychologist in Atascadero, CA
• Providers in Atascadero, 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 10, 2013; 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.