Active NPI
Michael Jenkins-Guarnieri, PH.D.
- Clinical Psychologist
- Tacoma, WA
National Provider Identifier
1588098214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60468244
- Practice address
- 1530 S Union Ave
Suites 14 & 16
Tacoma, WA 98405-1954 - Phone
- (253) 752-7320
- NPI assigned
- Aug 29, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60468244 | WA | Primary |
Addresses
Primary practice location
1530 S Union Ave
Suites 14 & 16
Tacoma, WA 98405-1954
Mailing address
1530 S Union Ave
Suites 14 & 16
Tacoma, WA 98405-1954
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PY60468244 | Other | WA | PSYCHOLOGY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY60468244 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404345600000",
"number": "1588098214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 S UNION AVE",
"address_2": "SUITES 14 & 16",
"city": "TACOMA",
"state": "WA",
"postal_code": "984051954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 S UNION AVE",
"address_2": "SUITES 14 & 16",
"city": "TACOMA",
"state": "WA",
"postal_code": "984051954",
"telephone_number": "253-752-7320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS-GUARNIERI",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-29",
"last_updated": "2014-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60468244",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGY LICENSE",
"identifier": "PY60468244",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.