Active NPI
Heather A Clinkenbeard
- Clinical Psychologist
- Irvine, CA
National Provider Identifier
1841942109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY31273
- Practice address
- 2082 Michelson Dr Ste 214
Irvine, CA 92612-1212 - Phone
- (949) 946-8701
- NPI assigned
- Jan 18, 2022
- Last updated
- Jan 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY31273 | CA | Primary |
Addresses
Primary practice location
2082 Michelson Dr Ste 214
Irvine, CA 92612-1212
Mailing address
1 Alicante
Aliso Viejo, CA 92656-3850
Phone (949) 280-5774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 10, 2019 through Dec 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY31273 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642464000000",
"number": "1841942109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ALICANTE",
"city": "ALISO VIEJO",
"state": "CA",
"postal_code": "926563850",
"telephone_number": "949-280-5774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2082 MICHELSON DR STE 214",
"city": "IRVINE",
"state": "CA",
"postal_code": "926121212",
"telephone_number": "949-946-8701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINKENBEARD",
"first_name": "HEATHER",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-18",
"last_updated": "2022-01-18",
"certification_date": "2022-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY31273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.