Active NPI
Rika Tanaka
- Clinical Psychologist
- Coronado, CA
National Provider Identifier
1629691126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY30925
- Practice address
- 854 A Ave
Coronado, CA 92118-2646 - Phone
- (619) 354-4027
- NPI assigned
- May 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Psychologist | 103TH0004X | PSY30925 | CA | |
| Clinical Psychologist | 103TC0700X | PSY30925 | CA | Primary |
Addresses
Primary practice location
854 A Ave
Coronado, CA 92118-2646
Mailing address
PO Box 182208
Coronado, CA 92178-2208
Phone (619) 354-4027
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 8, 2021 through Dec 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY30925 | CA | MD | Health Psychologist |
| 30925 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coronado Psychological Associates | Clinical | Current | Accepting new patients |
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.
-
- Clinical Psychologist
- Coronado, CA
- NPI 1437768249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589846400000",
"number": "1629691126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 182208",
"city": "CORONADO",
"state": "CA",
"postal_code": "921782208",
"telephone_number": "619-354-4027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "854 A AVE",
"city": "CORONADO",
"state": "CA",
"postal_code": "921182646",
"telephone_number": "619-354-4027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANAKA",
"first_name": "RIKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-19",
"last_updated": "2020-05-19",
"certification_date": "2020-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "CA",
"license": "PSY30925",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY30925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coronado, CA
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- Youssef S Tanagho, MD, MPH
- Shelby Leah Teeter, LMFT
- Toyin J Thompson, LMFT
- Thrifty Payless Inc (Rite Aid Pharmacy 05655)
- Alyssa Sarah Tieber, DPT, ATC
- Tara Pundiak Toohey, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.