Alyssa Chimiklis

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY32438 Issued in CA

Practice address

2659 State St Ste 100
Carlsbad, CA 92008-1627

Phone

(781) 718-0002

NPI assigned

Dec 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Single Specialty

  NPD
• Montefiore Medical Center

  dba Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Dr. Jennifer Shapiro, PHD

  dba Everybody Behavioral Health

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1265937064
  NPD (past)

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1598476640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PASEO VILLAGE WAY APT 1815",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303252",
            "telephone_number": "781-718-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 STATE ST STE 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081627",
            "telephone_number": "781-718-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMIKLIS",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024083",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY32438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soulynda Chheuy
• Jane Chiem
• Jasmin Felica Chihocky
• Child Psychology Center, Inc.
• Jordan Chillinsky, LCGC
• Charlotte Chin
• Lani Mei Chin
• Gloria Chio
• Alyssa Chisnell
• William J Cho, DDS, MS

• Clinical Child & Adolescent Psychologist in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.