Individual provider Active NPI

Ann Elkin, PH.D

  • Clinical Psychologist
  • Pacific Grove, CA
National Provider Identifier
1578870382
Registry record updated Jun 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 4334 Issued in CA
Practice address
92 Glen Lake Dr
Pacific Grove, CA 93950-5376
Phone
(831) 747-2484
NPI assigned
Sep 1, 2010
Last updated
Jun 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 4334 CA Primary

Addresses

Primary practice location

92 Glen Lake Dr
Pacific Grove, CA 93950-5376

Mailing address

1120 Forest Ave
Pacific Grove, CA 93950-5105
Phone (831) 747-2484

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160504001781 CA Practitioner - Clinical Psychologist 2961701412 Practice locations: Carmel, CA; Monterey, CA; Pacific Grove, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

92 Glen Lake Dr
Pacific Grove, CA 93950-5376
Phone (831) 747-2484

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 4334CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Songbird Care Homes LLC PastSince Mar 11, 2025 Accepting new patients
Sand Coast Rehab Physical Therapy Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466208000000",
    "number": "1578870382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 FOREST AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939505105",
            "telephone_number": "831-747-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 GLEN LAKE DR",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939505376",
            "telephone_number": "831-747-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKIN",
        "first_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2016-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 4334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

Verify at the official NPI Registry.