Organization Active NPI

Julie Manoogian PSYD Psychologist Apc

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1851924401
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
JULIE MANOOGIAN PSYD PSYCHOLOGIST APC
Practice address
12625 High Bluff Dr Ste 202
San Diego, CA 92130-2053
Phone
(858) 213-1014
NPI assigned
Feb 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Julie Manoogian, PSYDNPI 1922658418
Title
President / Owner
Phone
(858) 213-1014

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 Primary

Addresses

Primary practice location

12625 High Bluff Dr Ste 202
San Diego, CA 92130-2053

Mailing address

12625 High Bluff Dr Ste 202
San Diego, CA 92130-2053
Phone (858) 213-1014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200514002778 CA Part B Supplier - Clinic/Group Practice 1850722448 Receives reassigned benefits from 5 practitioners
Practice locations: La Jolla, CA

National Provider Directory

National Provider Directory

Locations

7514 Girard Ave
Ste 3
La Jolla, CA 92037
Phone (858) 213-1014

12625 High Bluff Dr
Ste 202
San Diego, CA 92130
Phone (858) 213-1014

Practitioners & affiliated clinicians

Practitioners 6

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": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1851924401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302053",
            "telephone_number": "858-213-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302053",
            "telephone_number": "858-213-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE MANOOGIAN PSYD PSYCHOLOGIST APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "MANOOGIAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "858-213-1014",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.