Individual provider Active NPI

Ralph Gunther Kuechle, PH.D.

  • Clinical Psychologist
  • Santa Ana, CA
National Provider Identifier
1780771253
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22751 Issued in CA
Practice address
3611 S Harbor Blvd
Suite 100
Santa Ana, CA 92704-6928
Phone
(714) 955-1766
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22751 CA Primary

Addresses

Primary practice location

3611 S Harbor Blvd
Suite 100
Santa Ana, CA 92704-6928

Mailing address

2129 E Taft Ave
Orange, CA 92867-4028
Phone (714) 345-3449

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
I20200213001195 CA Practitioner - Clinical Psychologist 7315373214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4631 Teller Ave
Suite 100
Newport Beach, CA 92660-8105
Phone (949) 887-7187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY22751CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Psychiatry & Mental Health, Professional Corporation CurrentSince Dec 23, 2019 Accepting new patients
HME Enterprises, Inc. Past Accepting new patients
South Coast Children's Society, Inc Past Accepting new patients

Locations

4631 Teller Ave
Ste 100
Newport Beach, CA 92660
Phone (949) 335-7500

4631 Teller Ave
Newport Beach, CA 92660
Phone (949) 292-1881

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1780771253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 E TAFT AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928674028",
            "telephone_number": "714-345-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S HARBOR BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046928",
            "telephone_number": "714-955-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUECHLE",
        "first_name": "RALPH",
        "middle_name": "GUNTHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.