Individual provider Active NPI

Toni Guajardo-Gonzalez, PH.D.

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1902965445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY11438 Issued in CA
Practice address
2810 E del Mar Blvd
Suite 5
Pasadena, CA 91107-4321
Phone
(626) 568-8336
Fax
(626) 568-9276
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY11438 CA Primary

Addresses

Primary practice location

2810 E del Mar Blvd
Suite 5
Pasadena, CA 91107-4321

Mailing address

2810 E del Mar Blvd
Suite 5
Pasadena, CA 91107-4321
Phone (626) 568-8336

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
I20120524000638 CA Practitioner - Clinical Psychologist 4284897406 Practice locations: Pasadena, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2810 E del Mar Blvd
Suite 5
Pasadena, CA 91107-4322
Phone (626) 568-8336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY11438CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902965445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 E DEL MAR BLVD",
            "address_2": "SUITE 5",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074321",
            "telephone_number": "626-568-8336",
            "fax_number": "626-568-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 E DEL MAR BLVD",
            "address_2": "SUITE 5",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074321",
            "telephone_number": "626-568-8336",
            "fax_number": "626-568-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUAJARDO-GONZALEZ",
        "first_name": "TONI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.