Individual provider Active NPI

Boikanyo P Tlhong, PSYD

  • Psychologist
  • San Diego, CA
National Provider Identifier
1790148526
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35016 Issued in CA
Practice address
8989 Rio San Diego Dr Ste 200
San Diego, CA 92108-1647
Phone
(858) 279-1223
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Psychologist 103T00000X 35016 CA Primary

Addresses

Primary practice location

8989 Rio San Diego Dr Ste 200
San Diego, CA 92108-1647

Mailing address

8989 Rio San Diego Dr Ste 200
San Diego, CA 92108-1647

Other practice location 1

1595 S 1st Ave
Yuma, AZ 85364-4706
Phone (928) 329-5855

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
I20240523003311 CA Practitioner - Clinical Psychologist 6901248848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy MD Medical Group Inc CurrentSince Mar 3, 2026 Accepting new patients
Telecare Mental Health Services of Arizona Inc Past Accepting new patients
Telecare Mental Health Services of Arizona, Inc Past Accepting new patients

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1790148526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8989 RIO SAN DIEGO DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8989 RIO SAN DIEGO DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081647",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1595 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853644706",
            "country_code": "US",
            "telephone_number": "928-329-5855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TLHONG",
        "first_name": "BOIKANYO",
        "middle_name": "P",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "35016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.