NPIMap

Organization Active NPI

Rady Children's Hospital

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1629219845
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22035 Issued in CA
Legal business name
RADY CHILDREN'S HOSPITAL
Practice address
3020 Childrens Way # Mc5081
San Diego, CA 92123-4223
Phone
(858) 576-1700
Fax
(858) 966-8495
NPI assigned
Mar 18, 2009
Last updated
Mar 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Authorized official

Name
Mrs. Christine Forest
Title
Contract Specialist
Phone
(858) 966-7716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22035 CA Primary

Addresses

Primary practice location

3020 Childrens Way # Mc5081
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

Other identifiers 1

IdentifierTypeStateIssuer
ZZZH3702ZOtherCABLUE SHIELD GROUP PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Children's Hospital H60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1629219845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-576-1700",
            "fax_number": "858-966-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5081",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-576-1700",
            "fax_number": "858-966-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADY CHILDREN'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "FOREST",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CONTRACT SPECIALIST",
        "authorized_official_telephone_number": "858-966-7716",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP PROVIDER NUMBER",
            "identifier": "ZZZH3702Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; 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.