Individual provider Active NPI

Natasha Radojevic, PSYD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1821365008
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28495 Issued in CA
Practice address
7011 Linda Vista Rd
San Diego, CA 92111-6307
Phone
(858) 810-8787
Fax
(858) 987-5825
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PSY28495 CA Primary

Addresses

Primary practice location

7011 Linda Vista Rd
San Diego, CA 92111-6307

Mailing address

6973 Linda Vista Rd
San Diego, CA 92111-6342
Phone (858) 279-9676

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
I20170926004236 CA Order and Referring Only - Clinical Psychologist 2668746801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28495CAMDClinical Psychologist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821365008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6973 LINDA VISTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116342",
            "telephone_number": "858-279-9676",
            "fax_number": "858-279-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 LINDA VISTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116307",
            "telephone_number": "858-810-8787",
            "fax_number": "858-987-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOJEVIC",
        "first_name": "NATASHA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.