Individual provider Active NPI

Modell McEntire

  • School Psychologist
  • Weaverville, CA
National Provider Identifier
1790630440
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
230089422 Issued in CA
Practice address
201 Memorial Drive
Weaverville, CA 96093
Phone
(530) 623-2861
NPI assigned
Feb 27, 2026
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 230089422 CA Primary

Addresses

Primary practice location

201 Memorial Drive
Weaverville, CA 96093

Mailing address

201 Memorial Drive
Weaverville, CA 96093
Phone (530) 623-2861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
230089422CAMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity County Office of Education Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1790630440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MEMORIAL DRIVE",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "96093",
            "telephone_number": "530-623-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MEMORIAL DRIVE",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "96093",
            "telephone_number": "530-623-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENTIRE",
        "first_name": "MODELL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "230089422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weaverville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.