Active NPI
Carolyn Boosalis Foley, PH.D.
- Clinical Psychologist
- Patton, CA
National Provider Identifier
1598095606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY31282
- Practice address
- 3102 E Highland Avenue
Medical Staff Office
Patton, CA 92369 - Phone
- (909) 425-7000
- Fax
- (909) 252-4055
- NPI assigned
- Jan 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY31282 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3102 E Highland Avenue
Medical Staff Office
Patton, CA 92369
Mailing address
3102 E Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7000
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY31282 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589414400000",
"number": "1598095606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3102 E HIGHLAND AVENUE",
"address_2": "MEDICAL STAFF OFFICE",
"city": "PATTON",
"state": "CA",
"postal_code": "92369",
"telephone_number": "909-425-7000",
"fax_number": "909-252-4055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3102 E HIGHLAND AVENUE",
"address_2": "MEDICAL STAFF OFFICE",
"city": "PATTON",
"state": "CA",
"postal_code": "92369",
"telephone_number": "909-425-7000",
"fax_number": "909-252-4055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLEY",
"first_name": "CAROLYN",
"middle_name": "BOOSALIS",
"name_prefix": "Ms.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-12",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY31282",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.