Individual provider Active NPI

Cynthia Ramirez Canul, PH.D.

  • Psychologist
  • Orange, CA
National Provider Identifier
1598156606
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
17733 Issued in CA
Practice address
295 N Rampart St Ste a
Orange, CA 92868-1866
Phone
(714) 704-4530
NPI assigned
Feb 10, 2015
Last updated
Feb 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 17733 CA Primary

Addresses

Primary practice location

295 N Rampart St Ste a
Orange, CA 92868-1866

Mailing address

295 N Rampart St Ste a
Orange, CA 92868-1866

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
I20210625001921 CA Practitioner - Clinical Psychologist 9537560784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17733CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. CurrentSince Jul 15, 2021 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

901 W Civic Center Dr
Fl 2
Santa Ana, CA 92703
Phone (951) 216-3549

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1598156606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 N RAMPART ST STE A",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 N RAMPART ST STE A",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681866",
            "telephone_number": "714-704-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANUL",
        "first_name": "CYNTHIA",
        "middle_name": "RAMIREZ",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "17733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.