Carol Ann Matthews, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY19603 Issued in CA

Practice address

28125 Bradley Rd Ste 220
Sun City, CA 92586-2288

Phone

(951) 309-2140

Fax

(951) 309-2141

NPI assigned

Jul 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Southern California Psychiatric Group, Inc

  • Child & Adolescent Psychiatry Physician
  • Sun City, CA
  • NPI 1285951871
  NPD (past)

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1770773236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28125 BRADLEY RD STE 220",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862288",
            "telephone_number": "951-309-2140",
            "fax_number": "951-309-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28125 BRADLEY RD STE 220",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862288",
            "telephone_number": "951-309-2140",
            "fax_number": "951-309-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PSYCHOLOGY",
            "identifier": "PSY19603",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Lopez
• Deane Manning
• Nataline Catherine Manning
• Benny Manrique Jr.
• Glenn A. Martin, D.D.S.
• Lisa D'Ann MC Cabe, DPT
• Erin Dorothy McIntosh, NP
• Xotchil Medrano, RBT
• Kayleen Mejia
• Shelley Lynn Mejia, DPT

• Clinical Psychologist in Sun City, CA
• Providers in Sun City, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.