Active NPI
Megan Nolan
- Clinical Psychologist
- Santa Rosa, CA
National Provider Identifier
1922574821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY11513
- Practice address
- 4378 Bennett Valley Rd
Santa Rosa, CA 95404-6239 - Phone
- (707) 291-6798
- Fax
- (707) 575-0886
- NPI assigned
- Oct 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY11513 | CA | Primary |
Addresses
Primary practice location
4378 Bennett Valley Rd
Santa Rosa, CA 95404-6239
Mailing address
4378 Bennett Valley Rd
Santa Rosa, CA 95404-6239
Phone (707) 291-6798
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200228001783 | CA | Practitioner - Clinical Psychologist | 5991043747 | Practice locations: Santa Rosa, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Southern Illinois University School of Medicine, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
4378 Bennett Valley Rd
Santa Rosa, CA 95404-6239
Phone (707) 291-6798
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11513 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1922574821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4378 BENNETT VALLEY RD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954046239",
"telephone_number": "707-291-6798",
"fax_number": "707-575-0886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4378 BENNETT VALLEY RD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954046239",
"telephone_number": "707-291-6798",
"fax_number": "707-575-0886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "MEGAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-17",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY11513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.