Individual provider Active NPI

Eileen Paniagua, PSY.D.

  • Clinical Neuropsychologist
  • Newport Beach, CA
National Provider Identifier
1760775704
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
26906 Issued in CA
Practice address
23 Corporate Plaza Dr
Suite 150
Newport Beach, CA 92660
Phone
(949) 887-2007
NPI assigned
May 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 26906 CA Primary

Addresses

Primary practice location

23 Corporate Plaza Dr
Suite 150
Newport Beach, CA 92660

Mailing address

23 Corporate Plaza Dr Ste 150
Newport Beach, CA 92660-7908
Phone (949) 887-2007

Other names 1

  • Eileen Abarca Former name

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
I20150827000718 CA Practitioner - Clinical Psychologist 5496061087 Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26906CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Integrative Health Current Accepting new patients
Newport Psychology Clinical Neuropsychologist CurrentSince Feb 1, 2018 Accepting new patients

Locations

30 Corporate Park
Ste 201
Irvine, CA 92606
Phone (949) 887-2007

23 Corporate Plaza Dr
Ste 150
Newport Beach, CA 92660
Phone (949) 329-3733

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": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1760775704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CORPORATE PLAZA DR STE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607908",
            "telephone_number": "949-887-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CORPORATE PLAZA DR",
            "address_2": "SUITE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-887-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANIAGUA",
        "first_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "26906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "ABARCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.