Benjamin G.L. Ford, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

25880 Issued in CA

Practice address

475-750 Rice Canyon Road
Susanville, CA 96130

Phone

(530) 251-5100

NPI assigned

Dec 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Remi Vista Inc.

  • Community/Behavioral Health Agency
  • Redding, CA
  • NPI 1194778803
  NPD (past)

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1619151073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475-750 RICE CANYON ROAD",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "96130",
            "telephone_number": "530-251-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475-750 RICE CANYON ROAD",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "96130",
            "telephone_number": "530-251-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "BENJAMIN",
        "middle_name": "G.L.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-20",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "25880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE NUMBER",
            "identifier": "25880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Anne Floyd
• Rhonda Marie Foley, LCSW, CATC
• Shirley Ann Foltz
• Carol Jane Forbes, SPPA
• Angela K Ford
• Darrell R Foster
• Micah James Freeman, MA, PPSC
• Dennis L French
• Katie Gaffney, LA.C.
• Earl Braden Gard IV, D.D.S.

• Psychologist in Susanville, CA
• Providers in Susanville, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.