Individual provider Active NPI

Cindy Mitchell, PHD

  • Clinical Psychologist
  • Atascadero, CA
National Provider Identifier
1801930078
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27392 Issued in CA
Practice address
3528 El Camino Real
Atascadero, CA 93422
Phone
(805) 391-4182
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY27392 CA
Clinical Psychologist 103TC0700X PSY27392 CA Primary
Forensic Psychologist 103TF0200X PSY27392 CA
Cognitive & Behavioral Psychologist 103TB0200X PSY27392 CA

Addresses

Primary practice location

3528 El Camino Real
Atascadero, CA 93422

Mailing address

3528 El Camino Real
Atascadero, CA 93422
Phone (805) 391-4182

Other names 1

  • Cindy Bryce Former name

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
I20160330002058 CA Practitioner - Clinical Psychologist 6002113412 Reassigns benefits to 1 organization
Practice locations: Atascadero, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3528 El Camino Real
Atascadero, CA 93422-2531
Phone (805) 391-4182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY27392CAMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Feb 21, 2016 Accepting new patients
Zenertree Psychological Treatment Center Inc. Clinical CurrentSince Feb 27, 2022 Accepting new patients
Department of State Hospitals Current Accepting new patients

Locations

3528 El Camino Real
Atascadero, CA 93422
Phone (323) 302-1564

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1801930078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "93422",
            "telephone_number": "805-391-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "93422",
            "telephone_number": "805-391-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CINDY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY27392",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27392",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY27392",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY27392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CINDY",
            "last_name": "BRYCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atascadero, CA

Sources for this page

Verify at the official NPI Registry.