Individual provider Active NPI

Eric John Reininga, PHD

  • Clinical Psychologist
  • Carmichael, CA
National Provider Identifier
1710146816
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY18803 Issued in CA
Practice address
2111 Shelfield Dr
Carmichael, CA 95608-5515
Phone
(916) 480-9770
Fax
(916) 480-9771
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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 PSY18803 CA Primary

Addresses

Primary practice location

2111 Shelfield Dr
Carmichael, CA 95608-5515

Mailing address

2111 Shelfield Dr
Carmichael, CA 95608-5515
Phone (916) 480-9770

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
I20160322001553 CA Practitioner - Clinical Psychologist 9638476435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

348 Iris Dr
Salinas, CA 93906-3514
Phone (888) 515-3834

5838 Edison PL
Suite 100
Carlsbad, CA 92008-5520
Phone (888) 515-3834

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY18803CAMDClinical Psychologist
18803CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Memory Check Psychological Services, a Professional Corporation Clinical CurrentSince Mar 1, 2016 Accepting new patients

Locations

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

4929 Wilshire Blvd
Ste 510
Los Angeles, CA 90010
Phone (562) 904-3999

348 Iris Dr
Salinas, CA 93906
Phone (831) 449-5496

7447 Sepulveda Blvd
Van Nuys, CA 91405
Phone (818) 787-3400

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1710146816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 SHELFIELD DR",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956085515",
            "telephone_number": "916-480-9770",
            "fax_number": "916-480-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 SHELFIELD DR",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956085515",
            "telephone_number": "916-480-9770",
            "fax_number": "916-480-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REININGA",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.