Individual provider Active NPI

Angelica Marcilia Thomas, PSYD

  • Psychologist
  • Riverside, CA
National Provider Identifier
1740983576
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
94026982 Issued in CA
Practice address
5051 Canyon Crest Dr Ste 204
Riverside, CA 92507-6035
Phone
(951) 682-1488
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 94026982 CA Primary

Addresses

Primary practice location

5051 Canyon Crest Dr Ste 204
Riverside, CA 92507-6035

Mailing address

5051 Canyon Crest Dr Ste 204
Riverside, CA 92507-6035
Phone (951) 682-1488

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

State licenses

LicenseStateTypeSpecialty
94026982CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Psychology Group, a Professional Corporation CurrentSince Mar 26, 2023 Accepting new patients

Locations

5051 Canyon Crest Dr
Ste 204
Riverside, CA 92507
Phone (951) 682-1488

Organizations & group practices 1

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1740983576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 CANYON CREST DR STE 204",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076035",
            "telephone_number": "951-682-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5051 CANYON CREST DR STE 204",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076035",
            "telephone_number": "951-682-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ANGELICA",
        "middle_name": "MARCILIA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "94026982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.