Individual provider Active NPI

Craig William Carlson, PH.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1821030677
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 10849 Issued in CA
Practice address
12625 High Bluff Dr
Suite 114-C
San Diego, CA 92130-2052
Phone
(760) 758-5680
Fax
(858) 755-2359
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 10849 CA Primary

Addresses

Primary practice location

12625 High Bluff Dr
Suite 114-C
San Diego, CA 92130-2052

Mailing address

PO Box 98
Carlsbad, CA 92018-0098
Phone (760) 758-5680

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
I20050816000512 CA Practitioner - Clinical Psychologist 1850321266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12625 High Bluff Dr
Suite 206
San Diego, CA 92130-2053
Phone (858) 755-2349

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 10849CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Carlson, PH.D., Psychologist, Inc. Psychologist CurrentSince Jan 21, 2005 Accepting new patients

Locations

12625 High Bluff Dr
Ste 206
San Diego, CA 92130
Phone (619) 654-4392

12625 High Bluff Dr
Ste 114C
San Diego, CA 92130
Phone (760) 494-0089

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821030677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920180098",
            "telephone_number": "760-758-5680",
            "fax_number": "858-755-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR",
            "address_2": "SUITE 114-C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302052",
            "telephone_number": "760-758-5680",
            "fax_number": "858-755-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CRAIG",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 10849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.