Individual provider Active NPI

Charlotte A. Sky, PH.D.

  • Clinical Psychologist
  • Pacific Grove, CA
National Provider Identifier
1659403624
Registry record updated Aug 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 8915 Issued in CA
Practice address
716 Lighthouse Ave
Ste D
Pacific Grove, CA 93950-2567
Phone
(831) 655-1404
Fax
(831) 288-2845
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 8915 CA Primary

Addresses

Primary practice location

716 Lighthouse Ave
Ste D
Pacific Grove, CA 93950-2567

Mailing address

PO Box 21
Pebble Beach, CA 93953-0021
Phone (831) 655-1404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100719000462 CA Practitioner - Clinical Psychologist 1850423302 Practice locations: Pacific Grove, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

716 Lighthouse Ave
Suite D
Pacific Grove, CA 93950-2567
Phone (831) 655-1404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 8915CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535241600000",
    "number": "1659403624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21",
            "city": "PEBBLE BEACH",
            "state": "CA",
            "postal_code": "939530021",
            "telephone_number": "831-655-1404",
            "fax_number": "831-288-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 LIGHTHOUSE AVE",
            "address_2": "STE D",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939502567",
            "telephone_number": "831-655-1404",
            "fax_number": "831-288-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKY",
        "first_name": "CHARLOTTE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2018-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 8915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

Verify at the official NPI Registry.