Michael Preston Uthoff, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

27619 Issued in CA

Practice address

541 S Glendora Ave
Glendora, CA 91741-6209

Phone

(314) 307-1307

NPI assigned

Nov 18, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 20, 2019 through Feb 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Advanced Mindset Psychological Services

  • Mental Health Counselor
  • Glendora, CA
  • NPI 1063903425
  NPD (past) Authorized official

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510963200000",
    "number": "1639683295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 LOWELL AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412449",
            "telephone_number": "314-307-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S GLENDORA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917416209",
            "telephone_number": "314-307-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTHOFF",
        "first_name": "MICHAEL",
        "middle_name": "PRESTON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-18",
        "last_updated": "2017-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "27619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Unique Healthcare, Inc.
• United Assistance Medical Gear
• United Family Physicians, Inc.
• United Therapy Network Inc
• Donald L Unruh, PHD
• Mayank J Vakil, M.D.
• Crystal Ruby Valdez, A.C.S.W.
• Kristina Valencia, RN
• Irene Denise Valenzuela, NP
• Janeil Marie Valenzuela, RN

• Clinical Psychologist in Glendora, CA
• Providers in Glendora, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.