Active NPI
Virginia Coyle, PSY.D.
- Psychologist
- Long Beach, CA
National Provider Identifier
1811017403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 27169
- Practice address
- 3711 Long Beach Blvd Ste 4065
Long Beach, CA 90807-3315 - Phone
- (562) 685-3016
- Fax
- (562) 318-3081
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 27169 | CA | Primary |
Addresses
Primary practice location
3711 Long Beach Blvd Ste 4065
Long Beach, CA 90807-3315
Mailing address
3711 Long Beach Blvd Ste 4065
Long Beach, CA 90807-3315
Phone (562) 685-3016
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170206001024 | CA | Practitioner - Clinical Psychologist | 0042593642 | Practice locations: Long Beach, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3711 Long Beach Blvd
Long Beach, CA 90807-3315
Phone (562) 858-3466
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27169 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunny Johnson, Licensed Clinical Social Worker, a Professional Corp | 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 and National Provider Directory roles.
-
- Clinical Social Worker
- Long Beach, CA
- NPI 1558927848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1811017403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3711 LONG BEACH BLVD STE 4065",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908073315",
"telephone_number": "562-685-3016",
"fax_number": "562-318-3081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3711 LONG BEACH BLVD STE 4065",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908073315",
"telephone_number": "562-685-3016",
"fax_number": "562-318-3081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COYLE",
"first_name": "VIRGINIA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "27169",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "25825 Vermont Ave",
"city": "Harbor City",
"state": "CA",
"country_code": "US",
"postal_code": "907103518",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.