Individual provider Active NPI

Patricia Del Valle, PSY.D

  • Clinical Psychologist
  • Glendora, CA
National Provider Identifier
1740308477
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY23550 Issued in CA
Practice address
1160 S Grand Ave
Glendora, CA 91740-5000
Phone
(626) 807-1783
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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 PSY23550 CA Primary

Addresses

Primary practice location

1160 S Grand Ave
Glendora, CA 91740-5000

Mailing address

1160 S Grand Ave
Glendora, CA 91740-5000
Phone (626) 335-5980

Other practice location 1

415 W Route 66 Ste 202
Glendora, CA 91740-4335
Phone (626) 963-4467

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120815000655 CA Practitioner - Clinical Psychologist 2668628199 Practice locations: Glendora, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 W Route 66
Suite 202
Glendora, CA 91740-4335
Phone (626) 963-4467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY23550CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Perkins Counseling and Psychological Services, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Pacific Clinics PastSince Jul 8, 2012 Accepting new patients

Locations

10580 Ligon Mill Rd
#210
Wake Forest, NC 27587
Phone (919) 263-9592

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: patricia.delvalle.p8@direct.bfmc.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1740308477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405000",
            "telephone_number": "626-335-5980",
            "fax_number": "626-335-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405000",
            "telephone_number": "626-807-1783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 W Route 66 Ste 202",
            "address_purpose": "LOCATION",
            "city": "Glendora",
            "state": "CA",
            "postal_code": "917404335",
            "country_code": "US",
            "telephone_number": "626-963-4467",
            "fax_number": "626-963-9543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEL VALLE",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.