Active NPI
Michael Robert Reider, PH.D.
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1942299532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY13784
- Practice address
- 9750 Miramar Road
Suite 210
San Diego, CA 92126-4562 - Phone
- (888) 293-3182
- Fax
- (888) 293-3182
- NPI assigned
- Oct 17, 2005
- Sex
- Male
- Sole proprietor
- No
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 | PSY13784 | CA | Primary |
Addresses
Primary practice location
9750 Miramar Road
Suite 210
San Diego, CA 92126-4562
Mailing address
9750 Miramar Road
Suite 210
San Diego, CA 92126-4562
Phone (888) 293-3182
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY137840 | Other | CA | MEDI-CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY13784 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael R. Reider, PH.D., Apc | Clinical | 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.
-
- Clinical Psychologist
- San Diego, CA
- NPI 1659305613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1942299532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9750 MIRAMAR ROAD",
"address_2": "SUITE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921264562",
"telephone_number": "888-293-3182",
"fax_number": "888-293-3182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9750 MIRAMAR ROAD",
"address_2": "SUITE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921264562",
"telephone_number": "888-293-3182",
"fax_number": "888-293-3182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIDER",
"first_name": "MICHAEL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY13784",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "PSY137840",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.