Individual provider Active NPI

Michelle Lynn Dean, PSY.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1629326566
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31875 Issued in CA
Practice address
3760 Sports Arena Blvd Ste 9
San Diego, CA 92110-5134
Phone
(858) 848-0616
Fax
(858) 614-7088
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY31875 CA Primary

Addresses

Primary practice location

3760 Sports Arena Blvd Ste 9
San Diego, CA 92110-5134

Mailing address

PO Box 342
Poway, CA 92074-0342

Other practice location 1

10700 Santa Monica Blvd Ste 310
Los Angeles, CA 90025-6588
Phone (866) 230-8275

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HBFF Direct

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
I20200720001071 CA Practitioner - Clinical Psychologist 2567886922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1902 Wright PL
FL 2
Carlsbad, CA 92008-6583
Phone (888) 515-3834

3760 Sports Arena Blvd
Suite 9
San Diego, CA 92110-5134
Phone (858) 333-2336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY31875CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Memory Check Psychological Services, a Professional Corporation Clinical CurrentSince Oct 21, 2024 Accepting new patients

Locations

1902 Wright Pl
Fl 2
Carlsbad, CA 92008
Phone (929) 468-2465

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

348 Iris Dr
Salinas, CA 93906
Phone (831) 449-5496

7447 Sepulveda Blvd
Van Nuys, CA 91405
Phone (818) 787-3400

Organizations & group practices 2

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": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1629326566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920740342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 SPORTS ARENA BLVD STE 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105134",
            "telephone_number": "858-848-0616",
            "fax_number": "858-614-7088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10700 Santa Monica Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900256588",
            "country_code": "US",
            "telephone_number": "866-230-8275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HBFF",
            "affiliation": "N",
            "endpointDescription": "HBFF",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10700 Santa Monica Blvd Ste 310",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900256588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.