Individual provider Active NPI

Tammy Grabreck, PH.D.

  • Clinical Neuropsychologist
  • Redding, CA
National Provider Identifier
1922411396
Registry record updated Dec 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY 26823 Issued in CA
Practice address
1640 Tehama St
Suite C
Redding, CA 96001-1681
Phone
(530) 710-1070
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY 26823 CA Primary

Addresses

Primary practice location

1640 Tehama St
Suite C
Redding, CA 96001-1681

Mailing address

1640 Tehama St
Suite C
Redding, CA 96001-1681
Phone (530) 710-1070

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
I20150302001276 CA Practitioner - Clinical Psychologist 2860718244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2628 Victor Ave
Suite B
Redding, CA 96002-1454
Phone (530) 710-1070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 26823CAMDClinical Neuropsychologist

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419638400000",
    "number": "1922411396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 TEHAMA ST",
            "address_2": "SUITE C",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011681",
            "telephone_number": "530-710-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 TEHAMA ST",
            "address_2": "SUITE C",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011681",
            "telephone_number": "530-710-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABRECK",
        "first_name": "TAMMY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 26823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.