Ranielle Lea Blohm, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

32319 Issued in CA

Practice address

821 E Accipiter Cir
Clarksville, TN 37043-2711

Phone

(949) 421-9127

NPI assigned

Jul 23, 2015

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Dr. Rainelle Lea Smith Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 28, 2022.

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1649655358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 HWY 104",
            "city": "IONE",
            "state": "CA",
            "postal_code": "95640",
            "telephone_number": "209-274-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E ACCIPITER CIR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432711",
            "telephone_number": "949-421-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOHM",
        "first_name": "RANIELLE",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "32319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAINELLE",
            "last_name": "SMITH",
            "middle_name": "LEA",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Clarksville, TN
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.