Individual provider Active NPI

Caprice Haverty, PH.D.

  • Clinical Psychologist
  • Concord, CA
National Provider Identifier
1922398460
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13202 Issued in CA
Practice address
2827 Concord Blvd
Concord, CA 94519-2608
Phone
(925) 685-9670
Fax
(925) 685-1528
NPI assigned
Apr 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY13202 CA Primary
Forensic Psychologist 103TF0200X PSY13202 CA

Addresses

Primary practice location

2827 Concord Blvd
Concord, CA 94519-2608

Mailing address

2827 Concord Blvd
Concord, CA 94519-2608
Phone (925) 685-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2016 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13202CAMDForensic Psychologist
13202CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
A Step Forward Past Accepting new patients

Organizations & group practices 1

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1922398460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 CONCORD BLVD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192608",
            "telephone_number": "925-685-9670",
            "fax_number": "925-685-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 CONCORD BLVD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192608",
            "telephone_number": "925-685-9670",
            "fax_number": "925-685-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERTY",
        "first_name": "CAPRICE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13202",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY13202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.