NPIMap

Organization Active NPI

Sunrise Psychological Services

  • Clinical Psychologist
  • Roseville, CA
National Provider Identifier
1831685197
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13572 Issued in CA
Legal business name
SUNRISE PSYCHOLOGICAL SERVICES
Practice address
729 Sunrise Ave Ste 101
Roseville, CA 95661
Phone
(916) 782-3800
Fax
(916) 782-3820
NPI assigned
Jul 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Stephen Gary McClure, PH.D.NPI 1811061864
Title
Psychologist
Phone
(916) 782-3800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY13572 CA Primary

Addresses

Primary practice location

729 Sunrise Ave Ste 101
Roseville, CA 95661

Mailing address

729 Sunrise Ave Ste 101
Roseville, CA 95661-4504
Phone (916) 782-3800

Other identifiers 1

IdentifierTypeStateIssuer
OPL135720MedicaidCA

National Provider Directory

National Provider Directory

Locations

729 Sunrise Ave
Ste 101
Roseville, CA 95661
Phone (916) 771-7852

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1831685197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 SUNRISE AVE STE 101",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614504",
            "telephone_number": "916-782-3800",
            "fax_number": "916-782-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 SUNRISE AVE STE 101",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-782-3800",
            "fax_number": "916-782-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "916-782-3800",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OPL135720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.