Robert Charles McMahon, PH.D.
Individual provider Active NPI Clinical Psychologist · Represa, CA
NPI 1972843142 · NPPES record last updated Feb 25, 2013
Key facts
- NPI
- 1972843142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY17491 (CA)
- Practice address
- 300 Prison Rd
Folsom State Prison
Represa, CA 95671-3001 - Phone
- (916) 985-2561
- NPI assigned
- Feb 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY17491 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY17491 | CA | Yes |
Addresses
Primary practice location
300 Prison Rd
Folsom State Prison
Represa, CA 95671-3001
Mailing address
949 University Ave
Suite 210
Sacramento, CA 95825-6728
Phone (916) 290-3995
Other providers in Represa, CA
- Kathryn Manness
- Kirsten Marie Mason
- Margaret A McAloon
- Matthew Erik McGiffen
- Timothea Greer McGinley
- Gary J McManus
- Sunny McQuillin
- Brianna Leigh Mead
- Molly Josslyn Michau
- Gianna Milazzo
All providers in Represa, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.