Individual provider Active NPI

Teri M Pokrajac, PSY.D.

  • Psychologist
  • Newport Beach, CA
National Provider Identifier
1891900940
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
15458 Issued in CA
Practice address
4060 Campus Dr
Ste. 120
Newport Beach, CA 92660-2217
Phone
(949) 475-0145
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 15458 CA Primary

Addresses

Primary practice location

4060 Campus Dr
Ste. 120
Newport Beach, CA 92660-2217

Mailing address

4060 Campus Dr
Ste. 120
Newport Beach, CA 92660-2217
Phone (949) 475-0145

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120327000870 CA Practitioner - Clinical Psychologist 5597925677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15458CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Teri M. Pokrajac, Psy.D. & Associates Psychologist PastSince Sep 14, 1998 Accepting new patients

Organizations & group practices 2

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1891900940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR",
            "address_2": "STE. 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602217",
            "telephone_number": "949-475-0145",
            "fax_number": "949-475-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR",
            "address_2": "STE. 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602217",
            "telephone_number": "949-475-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKRAJAC",
        "first_name": "TERI",
        "middle_name": "M",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "15458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.