Individual provider Active NPI

Carolina Meza Perez, PSY.D.

  • Clinical Psychologist
  • North Las Vegas, NV
National Provider Identifier
1942676994
Registry record updated Aug 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY1081 Issued in NV
Practice address
6733 Fireball CT
North Las Vegas, NV 89084-2571
Phone
(702) 473-0232
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Rehabilitation Counselor 225C00000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PY1081 NV Primary

Addresses

Primary practice location

6733 Fireball CT
North Las Vegas, NV 89084-2571

Mailing address

6733 Fireball CT
North Las Vegas, NV 89084-2571
Phone (702) 473-0232

Other practice location 1

2121 W Temple St Bldg ABC
Los Angeles, CA 90026-4915
Phone (213) 385-5100

Other practice location 2

6454 Van Nuys Blvd
Ste 111
Van Nuys, CA 91401-1445
Phone (626) 607-1146

Other identifiers 1

IdentifierTypeStateIssuer
1942676994MedicaidCA

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

LicenseStateTypeSpecialty
PY1081NVMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Communities CurrentSince Aug 14, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659744000000",
    "number": "1942676994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6733 FIREBALL CT",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890842571",
            "telephone_number": "702-473-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6733 FIREBALL CT",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890842571",
            "telephone_number": "702-473-0232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 W Temple St Bldg ABC",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900264915",
            "country_code": "US",
            "telephone_number": "213-385-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6454 Van Nuys Blvd",
            "address_2": "Ste 111",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914011445",
            "country_code": "US",
            "telephone_number": "626-607-1146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEZA PEREZ",
        "first_name": "CAROLINA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2022-08-06",
        "certification_date": "2022-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "NV",
            "license": "PY1081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942676994",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.