Individual provider Active NPI

Mark Wilson Schlutsmeyer, PH.D.

  • Clinical Psychologist
  • Yuba City, CA
National Provider Identifier
1821124124
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21636 Issued in CA
Practice address
1965 Live Oak Blvd
Yuba City, CA 95991-8828
Phone
(530) 822-7200
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY21636 CA Primary

Addresses

Primary practice location

1965 Live Oak Blvd
Yuba City, CA 95991-8828

Mailing address

1400 Crescent CT
Yuba City, CA 95991-6713
Phone (530) 822-9690

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
I20221005002858 CA Practitioner - Clinical Psychologist 8729464334 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY21636CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sutter CurrentSince Sep 20, 2022 Accepting new patients
County of Sutter CurrentSince Sep 20, 2022 Accepting new patients

Locations

545 Garden Hwy
Ste B
Yuba City, CA 95991
Phone (530) 674-1885

1965 Live Oak Blvd
Yuba City, CA 95991
Phone (530) 673-8255

1965 Live Oak Blvd
Ste A
Yuba City, CA 95991
Phone (530) 822-7513

Organizations & group practices 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1821124124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CRESCENT CT",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959916713",
            "telephone_number": "530-822-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959918828",
            "telephone_number": "530-822-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUTSMEYER",
        "first_name": "MARK",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.