NPIMap

Organization Active NPI

J Roland Fleck

Doing business as Encinitas Psychological Services

  • Clinical Psychologist
  • Encinitas, CA
National Provider Identifier
1770764847
Registry record updated Nov 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 5502 Issued in CA
Legal business name
J ROLAND FLECK
Doing business as
Encinitas Psychological Services
Practice address
4405 Manchester Ave
Suite 103
Encinitas, CA 92024-4940
Phone
(760) 942-1210
Fax
(760) 942-3865
NPI assigned
Nov 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2007

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

Authorized official

Name
Dr. J Roland Fleck, EDDNPI 1497925093
Title
Owner and Licensed Psychologist
Phone
(760) 942-1210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY 5502 CA Primary

Addresses

Primary practice location

4405 Manchester Ave
Suite 103
Encinitas, CA 92024-4940

Mailing address

4405 Manchester Ave
Suite 103
Encinitas, CA 92024-4940
Phone (760) 942-1210

Other names 1

  • Encinitas Psychological Services Doing business as

National Provider Directory

National Provider Directory

Locations

4405 Manchester Ave
Ste 103
Encinitas, CA 92024
Phone (760) 448-0936

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195257600000",
    "number": "1770764847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244940",
            "telephone_number": "760-942-1210",
            "fax_number": "760-942-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244940",
            "telephone_number": "760-942-1210",
            "fax_number": "760-942-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J ROLAND FLECK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-17",
        "last_updated": "2007-11-17",
        "status": "A",
        "authorized_official_last_name": "FLECK",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "ROLAND",
        "authorized_official_title_or_position": "OWNER AND LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "760-942-1210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 5502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Encinitas Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; 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.