Michael Bucaro, PSY.D
Individual provider Active NPI Clinical Psychologist · Avenal, CA
NPI 1649358292 · NPPES record last updated Mar 17, 2014
Key facts
- NPI
- 1649358292
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY 17844 (CA)
- Practice address
- 1 Kings Way
Avenal, CA 93204-9708 - Phone
- (559) 386-0587
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17844 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 17844 | CA | Yes |
Addresses
Primary practice location
1 Kings Way
Avenal, CA 93204-9708
Mailing address
590 Park Ave
Laguna Beach, CA 92651-2339
Phone (949) 922-7844
Other providers in Avenal, CA
- Avenal Medical Center
- Petra G Baltierrez
- Cony Rose Manalang Bencito
- Denise Benitez Rodriguez
- Meet Boparai
- Sarah Buck
- William Burns
- Dieu Ngoc Cao
- Central Valley Maternal & Child Care Centers
- Karen Marie Christensen
All providers in Avenal, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.