Active NPI
Norma Jean Van Volkinburg, PSYCHOLOGIST
- Clinical Psychologist
- Travis Afb, CA
National Provider Identifier
1871764076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY#17186
- Practice address
- 101 Bodin Cir
Travis Afb, CA 94535-1809 - Phone
- (707) 423-5174
- NPI assigned
- Mar 14, 2008
- Reactivated
- Dec 29, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 17186 | CA | |
| Clinical Psychologist | 103TC0700X | PSY#17186 | CA | Primary |
Addresses
Primary practice location
101 Bodin Cir
Travis Afb, CA 94535-1809
Mailing address
101 Bodin Cir
Travis Afb, CA 94535-1809
Phone (707) 423-5174
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17186 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY#17186 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1871764076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-5174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-5174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN VOLKINBURG",
"first_name": "NORMA",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-14",
"last_updated": "2023-08-07",
"certification_date": "2023-08-07",
"deactivation_date": "2010-05-07",
"reactivation_date": "2010-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "17186",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY#17186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Travis Afb, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.