Individual provider Active NPI

Ginette Denise Perrin, PSY.D.

  • Clinical Psychologist
  • Temecula, CA
National Provider Identifier
1780812420
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 22749 Issued in CA
Practice address
28936 Old Town Front St
Suite 102
Temecula, CA 92590-2890
Phone
(619) 955-2059
Fax
(760) 645-7059
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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 PSY 22749 CA Primary

Addresses

Primary practice location

28936 Old Town Front St
Suite 102
Temecula, CA 92590-2890

Mailing address

28936 Old Town Front St
Suite 102
Temecula, CA 92590-2890
Phone (619) 955-2059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 22749CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1780812420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28936 OLD TOWN FRONT ST",
            "address_2": "SUITE 102",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902890",
            "telephone_number": "619-955-2059",
            "fax_number": "760-645-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28936 OLD TOWN FRONT ST",
            "address_2": "SUITE 102",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902890",
            "telephone_number": "619-955-2059",
            "fax_number": "760-645-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRIN",
        "first_name": "GINETTE",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.