Individual provider Active NPI

Amy Eargle, PH.D.

  • Forensic Psychologist
  • Sacramento, CA
National Provider Identifier
1629247143
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
PSY15890 Issued in CA
Practice address
8439 Mediterranean Way
Sacramento, CA 95826-1667
Phone
(916) 216-8824
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY15890 CA
Forensic Psychologist 103TF0200X PSY15890 CA Primary
Health Psychologist 103TH0004X PSY15890 CA

Addresses

Primary practice location

8439 Mediterranean Way
Sacramento, CA 95826-1667

Mailing address

2443 Fair Oaks Blvd # 354
Sacramento, CA 95825-7684
Phone (916) 216-8824

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
I20191022003884 CA Practitioner - Clinical Psychologist 1254663370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chapa-de Indian Health Program, Inc.Group PAC ID 4981688520, 54 clinicians

Practice addresses (Care Compare)

11670 Atwood Rd
Auburn, CA 95603-9522
Phone (530) 887-2800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY15890CAMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chapa-de Indian Health Program, Inc. CurrentSince Aug 20, 2019 Accepting new patients

Locations

11670 Atwood Rd
Auburn, CA 95603
Phone (530) 887-2800

1350 E Main St
Grass Valley, CA 95945
Phone (530) 477-8545

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHHIAD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1629247143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 FAIR OAKS BLVD # 354",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958257684",
            "telephone_number": "916-216-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8439 MEDITERRANEAN WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958261667",
            "telephone_number": "916-216-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARGLE",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15890",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY15890",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "PSY15890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.