Active NPI
Michael McGlenn, PSYD
- Clinical Psychologist
- La Jolla, CA
National Provider Identifier
1942628326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32952
- Practice address
- 9500 Gilman Dr Galbraith Hall 190
La Jolla, CA 92093-6744 - Phone
- (858) 534-1737
- NPI assigned
- Apr 2, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 32952 | CA | Primary |
Addresses
Primary practice location
9500 Gilman Dr Galbraith Hall 190
La Jolla, CA 92093-6744
Mailing address
2749 Bellezza Dr
San Diego, CA 92108-6744
Phone (619) 985-0649
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32952 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662163200000",
"number": "1942628326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2749 BELLEZZA DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921086744",
"telephone_number": "619-985-0649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 GILMAN DR GALBRAITH HALL 190",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920936744",
"telephone_number": "858-534-1737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGLENN",
"first_name": "MICHAEL",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-02",
"last_updated": "2022-09-03",
"certification_date": "2022-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.