Carol Tyler, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

PSY12462 Issued in CA

Practice address

1941 Monterey Dr
San Bruno, CA 94066-2531

Phone

(650) 324-8727

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Seatac Senior Psychology LLCGroup PAC ID 7719032226, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Seatac Senior Psychology LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1831326834
  Medicare reassignment Care Compare group NPD
• Puget Sound Senior Psychology LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1487881488
  Medicare reassignment
• Seatac Senior Psychology LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1639306582
  NPD

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881715464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117357",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940117357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 MONTEREY DR",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662531",
            "telephone_number": "650-324-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY12462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Tung, PHARMD, BCPS
• Donka Dimitrova Turner
• Kayla Turner
• Angela Ivancich Turri
• Elizabeth Kristen Ty
• Nicole Uikilifi
• Hector Ulloa
• Noemi Umanzor
• Kaila Uniacke
• Sophia Uppal

• Cognitive & Behavioral Psychologist in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.