Individual provider Active NPI

Alice Thie Vieira, PH.D.

  • Psychologist
  • Newport Beach, CA
National Provider Identifier
1770615239
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 9614 Issued in CA
Practice address
2124 Vista Laredo
Newport Beach, CA 92660-4041
Phone
(949) 720-9464
Fax
(949) 760-1475
NPI assigned
Mar 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 9614 CA Primary

Addresses

Primary practice location

2124 Vista Laredo
Newport Beach, CA 92660-4041

Mailing address

2124 Vista Laredo
Newport Beach, CA 92660-4041
Phone (949) 720-9464

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
I20081217000402 CA Practitioner - Clinical Psychologist 0042372542 Practice locations: Newport Beach, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 9614CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770615239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 VISTA LAREDO",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926604041",
            "telephone_number": "949-720-9464",
            "fax_number": "949-760-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 VISTA LAREDO",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926604041",
            "telephone_number": "949-720-9464",
            "fax_number": "949-760-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIEIRA",
        "first_name": "ALICE",
        "middle_name": "THIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 9614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.