Individual provider Active NPI

Tamara L. Obregon Madera, PSY.D

  • Clinical Psychologist
  • Claremont, CA
National Provider Identifier
1851643712
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY30111 Issued in CA
Practice address
219 N Indian Hill Blvd Ste 202a
Claremont, CA 91711-4644
Phone
(626) 386-3036
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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 PSY30111 CA Primary

Addresses

Primary practice location

219 N Indian Hill Blvd Ste 202a
Claremont, CA 91711-4644

Mailing address

219 N Indian Hill Blvd Ste 202a
Claremont, CA 91711-4644
Phone (626) 386-3036

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY30111CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Joy in Healing Psychotherapy and Assessment, Inc. Clinical CurrentSince Jul 12, 2020 Accepting new patients
Brian Wu MD PHD Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

219 N Indian Hill Blvd
Ste 202A
Claremont, CA 91711
Phone (626) 372-2908

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

16890 Green Tree Blvd
Victorville, CA 92395
Phone (310) 273-4843

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1851643712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N INDIAN HILL BLVD STE 202A",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114644",
            "telephone_number": "626-386-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N INDIAN HILL BLVD STE 202A",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114644",
            "telephone_number": "626-386-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBREGON MADERA",
        "first_name": "TAMARA",
        "middle_name": "L.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.