Tara Cryderman, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29324 Issued in CA

Practice address

1156 High St
Santa Cruz, CA 95064-1077

Phone

(408) 899-0646

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Saint John'S Program for Real Change

  • Community/Behavioral Health Agency
  • Sacramento, CA
  • NPI 1467823674
  NPD (past)

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1881065993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 DUNSLEE WAY",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950663427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 HIGH ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950641077",
            "telephone_number": "408-899-0646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 57th St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172403",
            "country_code": "US",
            "telephone_number": "408-899-0646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRYDERMAN",
        "first_name": "TARA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "82992",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikal Cruz
• Rene Cruz, MA
• Cruz'N Anesthesia Associates
• Cruzmedmo
• Cruzmedmo
• Yolanda Cuadros, MD
• Nicollette Anne Cubbage, MA, CCC-SLP
• Patrick A Cudahy, MD
• Carina Cuellar Lucas
• Karen Cuencas

• All providers in Santa Cruz, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.