Individual provider Active NPI

Michelle Harriman, PSY.D.

  • Clinical Psychologist
  • Fullerton, CA
National Provider Identifier
1588799167
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19763 Issued in CA
Practice address
1440 N Harbor Blvd Ste 900
Fullerton, CA 92835-4122
Phone
(818) 269-7224
Fax
(772) 679-2402
NPI assigned
Feb 22, 2007
Last updated
Nov 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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 PSY19763 CA Primary

Addresses

Primary practice location

1440 N Harbor Blvd Ste 900
Fullerton, CA 92835-4122

Mailing address

1440 N Harbor Blvd Ste 900
Fullerton, CA 92835-4122
Phone (818) 269-7224

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

State licenses

LicenseStateTypeSpecialty
PSY19763CAMDClinical Psychologist

Organizations & group practices 1

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1588799167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 900",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354122",
            "telephone_number": "818-269-7224",
            "fax_number": "772-679-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 900",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354122",
            "telephone_number": "818-269-7224",
            "fax_number": "772-679-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIMAN",
        "first_name": "MICHELLE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.