Individual provider Active NPI

Yash P Manchanda, PHD

  • Psychologist
  • Pomona, CA
National Provider Identifier
1922028240
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY9836 Issued in CA
Practice address
3530 W Pomona Blvd
Pomona, CA 91769-0100
Phone
(909) 595-1221
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY9836 CA Primary

Addresses

Primary practice location

3530 W Pomona Blvd
Pomona, CA 91769-0100

Mailing address

1600 9TH St
RM 205 Mailstop 2-3
Sacramento, CA 95814-6414
Phone (916) 654-2431

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
I20110620000189 CA Practitioner - Clinical Psychologist 1456539543 Practice locations: Anaheim, CA; Stanton, CA; Yorba Linda, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5675 Scotch Pine RDG
Yorba Linda, CA 92886-5199
Phone (714) 488-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9836CAMDAddiction (Substance Use Disorder) Counselor
PSY9836CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of California - Department of Developmental Services Past Accepting new patients
Steven D Macina DO a Professional Medical Corporation Past Accepting new patients
New Horizon Lodge,Inc. Past Accepting new patients

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1922028240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH ST",
            "address_2": "RM 205 MAILSTOP 2-3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 W POMONA BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917690100",
            "telephone_number": "909-595-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHANDA",
        "first_name": "YASH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.