Individual provider Active NPI

Rhonda Lucy Hackshaw, PH.D.

  • Psychologist
  • La Jolla, CA
National Provider Identifier
1790950004
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY21101 Issued in CA
Practice address
9500 Gilman Dr
#0304
La Jolla, CA 92093-5004
Phone
(858) 534-5981
Fax
(858) 534-2628
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY21101 CA Primary
Counseling Psychologist 103TC1900X PSY21101 CA

Addresses

Primary practice location

9500 Gilman Dr
#0304
La Jolla, CA 92093-5004

Mailing address

9500 Gilman Dr
#0304
La Jolla, CA 92093-5004
Phone (858) 534-5981

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY21101CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1790950004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "address_2": "#0304",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920935004",
            "telephone_number": "858-534-5981",
            "fax_number": "858-534-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "address_2": "#0304",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920935004",
            "telephone_number": "858-534-5981",
            "fax_number": "858-534-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKSHAW",
        "first_name": "RHONDA",
        "middle_name": "LUCY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21101",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY21101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.