Individual provider Active NPI

Christine Ricketts, DO

  • Psychiatry Physician
  • Laguna Hills, CA
National Provider Identifier
1891180444
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
17340 Issued in CA
Practice address
23141 Moulton Pkwy Ste 213
Laguna Hills, CA 92653-1204
Phone
(949) 258-3741
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 17340 CA Primary

Addresses

Primary practice location

23141 Moulton Pkwy Ste 213
Laguna Hills, CA 92653-1204

Mailing address

23141 Moulton Pkwy Ste 213
Laguna Hills, CA 92653-1204

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
17340CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keeban Nam, M.D., Inc. CurrentSince Jan 22, 2023 Accepting new patients
Oak Health Center, a Medical Corporation Psychiatry PastSince Jan 26, 2020 Accepting new patients
Loyola University Medical Center Past Accepting new patients

Locations

23141 Moulton Pkwy
Ste 213
Laguna Hills, CA 92653
Phone (949) 258-3741

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1891180444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23141 MOULTON PKWY STE 213",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23141 MOULTON PKWY STE 213",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531204",
            "telephone_number": "949-258-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "CHRISTINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "17340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.