Active NPI
John Henry Massimino, M.D.
- Clinical Psychologist
- Laguna Niguel, CA
National Provider Identifier
1720282239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- A-36137
- Practice address
- 30262 Crown Valley Pkwy
Suite B-400
Laguna Niguel, CA 92677-2364 - Phone
- (949) 413-7315
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | A-36137 | CA | Primary |
Addresses
Primary practice location
30262 Crown Valley Pkwy
Suite B-400
Laguna Niguel, CA 92677-2364
Mailing address
30262 Crown Valley Pkwy
Suite B-400
Laguna Niguel, CA 92677-2364
Phone (949) 413-7315
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-36137 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1720282239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30262 CROWN VALLEY PKWY",
"address_2": "SUITE B-400",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926772364",
"telephone_number": "949-413-7315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30262 CROWN VALLEY PKWY",
"address_2": "SUITE B-400",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926772364",
"telephone_number": "949-413-7315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSIMINO",
"first_name": "JOHN",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-11",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "A-36137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Niguel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.