Individual provider Active NPI

Yvonne Fernandez Nobles, PSY D., L.P.

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1659371318
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP 4435 Issued in MN
Practice address
408 Saint Peter St
Suite 429
Saint Paul, MN 55102-1130
Phone
(651) 224-0614
Fax
(651) 224-5754
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP 4435 MN Primary

Addresses

Primary practice location

408 Saint Peter St
Suite 429
Saint Paul, MN 55102-1130

Mailing address

408 Saint Peter St
Suite D2
Saint Paul, MN 55102-1130
Phone (651) 224-0614

Other identifiers 3

IdentifierTypeStateIssuer
150003OtherUCARE
070L8N0OtherBC/BS
065841300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110225000708 MN Practitioner - Clinical Psychologist 3779764501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamm Memorial Psychiatric ClinicGroup PAC ID 8426000340, 13 clinicians

Practice addresses (Care Compare)

10 River Park PLZ
Suite 710
Saint Paul, MN 55107-1223
Phone (651) 224-0614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP 4435MNMDPsychologist

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1659371318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 SAINT PETER ST",
            "address_2": "SUITE D2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021130",
            "telephone_number": "651-224-0614",
            "fax_number": "651-224-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SAINT PETER ST",
            "address_2": "SUITE 429",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021130",
            "telephone_number": "651-224-0614",
            "fax_number": "651-224-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "YVONNE",
        "middle_name": "FERNANDEZ",
        "name_prefix": "Dr.",
        "credential": "PSY D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 4435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "150003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "070L8N0",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065841300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.