Carol Marie Elias, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 16418 Issued in CA

Practice address

2001 N Garey Ave
Ste. 107
Pomona, CA 91767-2773

Phone

(909) 622-0148

Fax

(909) 622-7101

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Joan M. Ybarra, PSYD., a Psychological Corporation

  • Clinical Psychologist
  • Covina, CA
  • NPI 1164520656
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1730249384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GAREY AVE",
            "address_2": "STE. 107",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672773",
            "telephone_number": "909-622-0148",
            "fax_number": "909-622-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N GAREY AVE",
            "address_2": "STE. 107",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672773",
            "telephone_number": "909-622-0148",
            "fax_number": "909-622-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "CAROL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 16418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OPL 164180",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1730035",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "208817",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US BEHAVIORAL HEALTH PLAN",
            "identifier": "61-95987",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "407529",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY164180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Denten E Eldredge, D.P.M.
• Ivonne Kimberly Elias
• Elim Medical, Inc.
• Elis Family Counseling Services
• Elite Medical Supply, Inc.
• Elite Travel LLC

• Clinical Psychologist in Pomona, CA
• Providers in Pomona, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.