Gina Neikirk

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY18601 Issued in CA

Practice address

33562 Yucaipa Blvd # 4-133
Yucaipa, CA 92399-2072

Phone

(909) 583-4040

Fax

(909) 217-3456

NPI assigned

Mar 8, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Gina Robinson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1740554757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33562 YUCAIPA BLVD # 4-133",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992072",
            "telephone_number": "909-583-4040",
            "fax_number": "909-217-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33562 YUCAIPA BLVD # 4-133",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992072",
            "telephone_number": "909-583-4040",
            "fax_number": "909-217-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIKIRK",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-10-7155",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY18601",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18601",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "CA",
            "license": "PSY18601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "ROBINSON",
            "credential": "PH.D., BCBA-D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychologist in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Psychologist in California

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