Active NPI
Alberto Ibarra
- Psychologist
- Blue Jay, CA
National Provider Identifier
1801279328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY32795
- Practice address
- PO Box 754
Blue Jay, CA 92317-0754 - Phone
- (909) 235-6326
- NPI assigned
- Jul 1, 2015
- Last updated
- Sep 12, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Psychologist | 103T00000X | PSY32795 | CA | Primary |
Addresses
Primary practice location
PO Box 754
Blue Jay, CA 92317-0754
Mailing address
PO Box 754
Blue Jay, CA 92317-0754
Phone (909) 235-6326
Other practice location 1
1001 Potrero Ave
San Francisco, CA 94110-3518
Phone (415) 206-5270
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY32795 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nova Mental Health | Current | 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.
-
- Adult Mental Health Clinic/Center
- Yucaipa, CA
- NPI 1912734476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1801279328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 754",
"city": "BLUE JAY",
"state": "CA",
"postal_code": "923170754",
"telephone_number": "909-235-6326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 754",
"city": "BLUE JAY",
"state": "CA",
"postal_code": "923170754",
"telephone_number": "909-235-6326"
}
],
"practiceLocations": [
{
"address_1": "1001 Potrero Ave",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941103518",
"country_code": "US",
"telephone_number": "415-206-5270",
"fax_number": "415-206-4722",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IBARRA",
"first_name": "ALBERTO",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-01",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY32795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Jay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.