Organization Active NPI

Palm Springs Neuropsychology

  • Clinical Neuropsychologist
  • Palm Springs, CA
National Provider Identifier
1831733195
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
PALM SPRINGS NEUROPSYCHOLOGY
Practice address
650 E Tahquitz Canyon Way Ste 2
Palm Springs, CA 92262-6714
Phone
(541) 257-5533
NPI assigned
Oct 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Authorized official

Name
Julien J Guillaumot, PHDNPI 1124079066
Title
Owner
Phone
(541) 257-5533

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 NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X Primary

Addresses

Primary practice location

650 E Tahquitz Canyon Way Ste 2
Palm Springs, CA 92262-6714

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200422002727 CA Part B Supplier - Clinic/Group Practice 2860822459 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Springs, CA

National Provider Directory

National Provider Directory

Locations

650 E Tahquitz Canyon Way
Ste 2
Palm Springs, CA 92262
Phone (415) 894-9879

Practitioners & affiliated clinicians

Practitioners 4

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": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1831733195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E TAHQUITZ CANYON WAY STE 2",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626714",
            "telephone_number": "541-257-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM SPRINGS NEUROPSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "GUILLAUMOT",
        "authorized_official_first_name": "JULIEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-257-5533",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.