Individual provider Active NPI

Angelina Marie Feagin, PHD

  • Clinical Psychologist
  • Rancho Cucamonga, CA
National Provider Identifier
1669071007
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSB94024796 Issued in CA
Practice address
10722 Arrow Rte Ste 314
Rancho Cucamonga, CA 91730-4811
Phone
(099) 484-8888
NPI assigned
Oct 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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 PSB94024796 CA Primary

Addresses

Primary practice location

10722 Arrow Rte Ste 314
Rancho Cucamonga, CA 91730-4811

Mailing address

10722 Arrow Rte Ste 314
Rancho Cucamonga, CA 91730-4811
Phone (099) 484-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSB94024796CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychological Associates & Wellness Center PC CurrentSince Feb 10, 2025 Accepting new patients

Locations

10722 Arrow Rte
Ste 314
Rancho Cucamonga, CA 91730
Phone (909) 367-3333

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": "1602892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1669071007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 314",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304811",
            "telephone_number": "099-484-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 314",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304811",
            "telephone_number": "099-484-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEAGIN",
        "first_name": "ANGELINA",
        "middle_name": "MARIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-17",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94024796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.