Active NPI
Sherry Ellison, PH.D.
- Psychologist
- Rancho Mirage, CA
National Provider Identifier
1942532619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 23224
- Practice address
- 41750 Rancho Las Palmas Dr
Suite L-4
Rancho Mirage, CA 92270-5511 - Phone
- (760) 250-5433
- NPI assigned
- Feb 5, 2010
- Last updated
- Mar 21, 2012
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 23224 | CA | Primary |
Addresses
Primary practice location
41750 Rancho Las Palmas Dr
Suite L-4
Rancho Mirage, CA 92270-5511
Mailing address
41750 Rancho Las Palmas Dr
Suite L-4
Rancho Mirage, CA 92270-5511
Phone (760) 250-5433
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 |
|---|---|---|---|---|
| I20110406000153 | CA | Practitioner - Clinical Psychologist | 8224212824 | Practice locations: Rancho Mirage, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
41750 Rancho Las Palmas Dr
Suite 4
Rancho Mirage, CA 92270-5514
Phone (760) 250-5433
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23224 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1942532619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41750 RANCHO LAS PALMAS DR",
"address_2": "SUITE L-4",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922705511",
"telephone_number": "760-250-5433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41750 RANCHO LAS PALMAS DR",
"address_2": "SUITE L-4",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922705511",
"telephone_number": "760-250-5433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "SHERRY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-05",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "23224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Mirage, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.