Individual provider Active NPI

Adielle Carrington, PSY.D.

  • Clinical Psychologist
  • Represa, CA
National Provider Identifier
1710246616
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY23522 Issued in CA
Practice address
100 Prison Rd
Represa, CA 95671-0012
Phone
(916) 985-8610
Fax
(916) 294-7839
NPI assigned
May 11, 2012
Last updated
May 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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 PSY23522 CA Primary

Addresses

Primary practice location

100 Prison Rd
Represa, CA 95671-0012

Mailing address

PO Box 290012
Represa, CA 95671-0012
Phone (916) 985-8610

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

State licenses

LicenseStateTypeSpecialty
PSY23522CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters PastSince Feb 9, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1710246616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290012",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956710012",
            "telephone_number": "916-985-8610",
            "fax_number": "916-294-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRISON RD",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956710012",
            "telephone_number": "916-985-8610",
            "fax_number": "916-294-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRINGTON",
        "first_name": "ADIELLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Represa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.