Mark H Michaels, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14795 Issued in CA

Practice address

110 Pine Ave.
#1070
Long Beach, CA 90802

Phone

(562) 212-6500

Fax

(866) 212-2809

NPI assigned

Feb 19, 2008

Last updated

Jan 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1710155171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PINE AVE.",
            "address_2": "#1070",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90802",
            "telephone_number": "562-212-6500",
            "fax_number": "866-212-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PINE AVE.",
            "address_2": "#1070",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90802",
            "telephone_number": "562-212-6500",
            "fax_number": "866-212-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY14795",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PSY14795",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael S. Johnson Physician Assistant, Inc.
• Michael Tehrani MD Apc
• Michael Wright
• Patricia Michael
• Jonathan Gregory Harris Michaels, DPT
• Peace Michaels
• Perla Michal
• David Edward Michalik, DO
• Hancy Michel
• Isabella Michel

• Clinical Psychologist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.