Bethany R Magnelli, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 22581 Issued in CA

Practice address

630 E Rialto Ave
San Bernardino, CA 92408-1292

Phone

(909) 386-0904

Fax

(909) 386-0912

NPI assigned

Apr 16, 2007

Last updated

Jul 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Bethany Rainaud Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Vericare of California Medical Group

  • Clinical Psychologist
  • Paradise, CA
  • NPI 1316992829
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1871718759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6713 INDIANA AVE",
            "address_2": "PMB #24",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064263",
            "telephone_number": "951-756-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIALTO AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924081292",
            "telephone_number": "909-386-0904",
            "fax_number": "909-386-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNELLI",
        "first_name": "BETHANY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 22581",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT41649",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "RAINAUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie Magana
• Oscar G Magana
• Celeste Magdaleno
• Magdi Elsaadi M.D. a Professional Medical Corporation
• Marlee Alejandra Maghlorio Salas
• Mila Grace Magpusao
• Joseph Magro, D.O.
• Reshma Nathraj Maharaj
• Amy D Mahmood
• Vinh Mai, D.O.

• Psychologist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.