Individual provider Active NPI

Antonia Ciovica, PH.D.

  • Psychologist
  • Redlands, CA
National Provider Identifier
1760510150
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
23593 Issued in CA
Practice address
1686 Barton Rd Ste E
Redlands, CA 92373-1489
Phone
(909) 558-9551
NPI assigned
Feb 28, 2007
Last updated
Jan 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 23593 CA Primary

Addresses

Primary practice location

1686 Barton Rd Ste E
Redlands, CA 92373-1489

Mailing address

1686 Barton Rd Ste E
Redlands, CA 92373-1489
Phone (909) 558-9551

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
I20110328000599 CA Practitioner - Clinical Psychologist 5597948604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, shared by 16 NPIs, 190 clinicians

Practice addresses (Care Compare)

26600 Cactus Ave
Moreno Valley, CA 92555-3901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
23593CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Psychologist CurrentSince Jan 16, 2011 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 16, 2011 Accepting new patients

Locations

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1686 Barton Rd
Ste E
Redlands, CA 92373
Phone (909) 558-9551

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1760510150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 BARTON RD STE E",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923731489",
            "telephone_number": "909-558-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1686 BARTON RD STE E",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923731489",
            "telephone_number": "909-558-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIOVICA",
        "first_name": "ANTONIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "23593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.