Individual provider Active NPI

Emily Beth Fine, PH.D.

  • Clinical Neuropsychologist
  • Ontario, CA
National Provider Identifier
1578849287
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY 23742 Issued in CA
Practice address
3281 E Guasti Rd Ste 700
Ontario, CA 91761-7643
Phone
(909) 480-8235
Fax
(909) 354-3363
NPI assigned
Oct 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 23742 CA
Clinical Neuropsychologist 103G00000X PSY 23742 CA Primary

Addresses

Primary practice location

3281 E Guasti Rd Ste 700
Ontario, CA 91761-7643

Mailing address

PO Box 1273
Claremont, CA 91711-1273
Phone (909) 480-8235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 23742CAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Beach Cities Psychological Services, Inc. Clinical Past Accepting new patients

Locations

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1578849287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1273",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111273",
            "telephone_number": "909-480-8235",
            "fax_number": "909-354-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3281 E GUASTI RD STE 700",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617643",
            "telephone_number": "909-480-8235",
            "fax_number": "909-354-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "EMILY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 23742",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 23742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.