Michelle Joanne Matusoff

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY15421 Issued in CA

Practice address

3101 W Coast Hwy
Newport Beach, CA 92663-4001

Phone

(800) 257-8715

Fax

(800) 819-1655

NPI assigned

Jun 5, 2006

Last updated

Feb 24, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Vericare of California Medical Group

  • Clinical Psychologist
  • Paradise, CA
  • NPI 1316992829
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1609815026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5267 WARNER AVE. #108",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926494517",
            "telephone_number": "949-275-5225",
            "fax_number": "714-377-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W COAST HWY",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634001",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSOFF",
        "first_name": "MICHELLE",
        "middle_name": "JOANNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOS ANGELES MEDICAL",
            "identifier": "PSY154211",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY154210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Houston Clark MD Inc (The Clark Center for Urogynecology)
• Matthew N. Koury, MD, MPH a Professional Corporation (Mind Health Institute, Newport Beach)
• Matthew R. Brown, Optometrist, a Professional Corporation
• Audrianne Jane Matthews
• Miriam Geraldine Matulich, RD
• Narges Maududi, MSW
• Jeffrey Maur, CRT
• Elsa Mawani
• Mark F Maxwell, DDS
• Cindy May, PH.D.

• Clinical Psychologist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.