Individual provider Active NPI

Andrew N Schwartz, PHD

  • Clinical Child & Adolescent Psychologist
  • Mission Viejo, CA
National Provider Identifier
1942323530
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY4989 Issued in CA
Practice address
23120 Alicia Pkwy
Suite 241
Mission Viejo, CA 92692-1210
Phone
(949) 588-5984
Fax
(949) 588-6355
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY4989 CA Primary

Addresses

Primary practice location

23120 Alicia Pkwy
Suite 241
Mission Viejo, CA 92692-1210

Mailing address

23120 Alicia Pkwy
Suite 241
Mission Viejo, CA 92692-1210
Phone (949) 588-5984

Other identifiers 1

IdentifierTypeStateIssuer
PSY4987OtherCASTATE LICENSE

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
I20050803001124 CA Practitioner - Clinical Psychologist 3779511340 Practice locations: Mission Viejo, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23120 Alicia Pkwy
Suite 241
Mission Viejo, CA 92692-1210
Phone (949) 588-5984

23120 Alicia Pky
Suite 241
Mission Viejo, CA 92692-1210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY4989CAMDClinical Child & Adolescent Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1942323530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23120 ALICIA PKWY",
            "address_2": "SUITE 241",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926921210",
            "telephone_number": "949-588-5984",
            "fax_number": "949-588-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23120 ALICIA PKWY",
            "address_2": "SUITE 241",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926921210",
            "telephone_number": "949-588-5984",
            "fax_number": "949-588-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "ANDREW",
        "middle_name": "N",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY4989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PSY4987",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.