Craig Alan Childress, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

61538481 Issued in WA

Practice address

2124 Bogie Dr
La Verne, CA 91750-1303

Phone

(909) 821-5398

NPI assigned

Apr 24, 2007

Last updated

Oct 6, 2026By the provider in NPPES

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tammy a Ouellette Psy.D. Apc

  • Psychologist
  • Fullerton, CA
  • NPI 1528246394
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1649499203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 BOGIE DR.",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505144",
            "telephone_number": "909-821-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 BOGIE DR",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917501303",
            "telephone_number": "909-821-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "CRAIG",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "61538481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil Chaudhari, PHARMD
• Amy Chen, RPH
• Janine N Chen, RPH
• Zongyun Chen, OTR/L
• Carole Ishan Chiang, D.P.M.
• Tony Chin, OTR/L
• Kyung Duk Choi, DDS
• Leeann Chu, DDS
• City of la Verne
• Robin Lorinne Clarkson, MPT

• Clinical Psychologist in La Verne, CA
• Providers in La Verne, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.