Active NPI
Michael Walter Flesock, PH.D.
- Clinical Psychologist
- Long Beach, CA
National Provider Identifier
1972704781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 9494
- Practice address
- 1045 Atlantic Ave
Suite 806
Long Beach, CA 90813-3408 - Phone
- (562) 590-5594
- Fax
- (562) 590-5596
- NPI assigned
- May 30, 2007
- 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 | PSY 9494 | CA | Primary |
Addresses
Primary practice location
1045 Atlantic Ave
Suite 806
Long Beach, CA 90813-3408
Mailing address
PO Box 461
Yorba Linda, CA 92885-0461
Phone (714) 779-5176
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 |
|---|---|---|---|
| PSY 9494 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972704781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 461",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928850461",
"telephone_number": "714-779-5176",
"fax_number": "714-779-5176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 ATLANTIC AVE",
"address_2": "SUITE 806",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133408",
"telephone_number": "562-590-5594",
"fax_number": "562-590-5596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLESOCK",
"first_name": "MICHAEL",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 9494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.