Active NPI
Stacy Delgado
- Counseling Psychologist
- Moreno Valley, CA
National Provider Identifier
1891807509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY 24095
- Practice address
- 12625 Frederick St Ste 15-102
Moreno Valley, CA 92553-5216 - Phone
- (916) 402-4948
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY 24095 | CA | Primary |
Addresses
Primary practice location
12625 Frederick St Ste 15-102
Moreno Valley, CA 92553-5216
Mailing address
12625 Frederick St Ste 15-102
Moreno Valley, CA 92553-5216
Phone (916) 402-4948
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160527000462 | CA | Practitioner - Clinical Psychologist | 7012207319 | Practice locations: Moreno Valley, CA; West Covina, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
25208 Jaclyn Ave
Moreno Valley, CA 92557-5740
Phone (916) 402-4948
824 W Cameron Ave
West Covina, CA 91790-4136
Phone (626) 962-3511
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 24095 | CA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1891807509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12625 FREDERICK ST STE 15-102",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925535216",
"telephone_number": "916-402-4948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12625 FREDERICK ST STE 15-102",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925535216",
"telephone_number": "916-402-4948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELGADO",
"first_name": "STACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY 24095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.