Individual provider Active NPI

Tristan Cole Buzzini, PSY.D

  • Clinical Psychologist
  • Stockton, CA
National Provider Identifier
1821352840
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27973 Issued in CA
Practice address
7707 Austin Rd
California Healthcare Facility
Stockton, CA 95215-8312
Phone
(650) 962-4428
Fax
(650) 962-4428
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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 PSY27973 CA Primary

Addresses

Primary practice location

7707 Austin Rd
California Healthcare Facility
Stockton, CA 95215-8312

Mailing address

PO Box 32050
California Healthcare Facility
Stockton, CA 95213-2050

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

LicenseStateTypeSpecialty
PSY27973CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1821352840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32050",
            "address_2": "CALIFORNIA HEALTHCARE FACILITY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952132050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 AUSTIN RD",
            "address_2": "CALIFORNIA HEALTHCARE FACILITY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952158312",
            "telephone_number": "650-962-4428",
            "fax_number": "650-962-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZZINI",
        "first_name": "TRISTAN",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.