Individual provider Active NPI

Thomas Arnold Hall, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Modesto, CA
National Provider Identifier
1710907340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY13196 Issued in CA
Practice address
1608 Sunrise Ave Ste 5
Suite 5
Modesto, CA 95350-4678
Phone
(209) 571-2733
Fax
(209) 527-6754
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY13196 CA Primary

Addresses

Primary practice location

1608 Sunrise Ave Ste 5
Suite 5
Modesto, CA 95350-4678

Mailing address

1608 Sunrise Ave Ste 5
Suite 5
Modesto, CA 95350-4678
Phone (209) 571-2733

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
PSY13196CAMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710907340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 SUNRISE AVE STE 5",
            "address_2": "SUITE 5",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504678",
            "telephone_number": "209-571-2733",
            "fax_number": "209-527-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 SUNRISE AVE STE 5",
            "address_2": "SUITE 5",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504678",
            "telephone_number": "209-571-2733",
            "fax_number": "209-527-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "THOMAS",
        "middle_name": "ARNOLD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY13196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.