Active NPI
Consuelo Flores, PSY D
- Rehabilitation Psychologist
- Walnut Creek, CA
National Provider Identifier
1982965091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- License
- PSY23668
- Practice address
- 454 N Wiget LN
Walnut Creek, CA 94598-2408 - Phone
- (925) 482-8111
- Fax
- (925) 482-1166
- NPI assigned
- Jun 5, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | PSY23668 | CA | Primary |
Addresses
Primary practice location
454 N Wiget LN
Walnut Creek, CA 94598-2408
Mailing address
450 N Wiget LN
Walnut Creek, CA 94598-2408
Phone (925) 691-9806
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY23668 | CA | MD | Rehabilitation Psychologist |
| 23668 | CA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Pacific Medical Group, Inc. | Past | Accepting new patients | |
| Trauma & Stress Recovery, a Medical Group Inc. | Rehabilitation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Oakland, CA
- NPI 1275002453
-
- Clinical Psychologist
- Oakland, CA
- NPI 1528676269
Rehabilitation
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1982965091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 N WIGET LN",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982408",
"telephone_number": "925-691-9806",
"fax_number": "925-691-9807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "454 N WIGET LN",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982408",
"telephone_number": "925-482-8111",
"fax_number": "925-482-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORES",
"first_name": "CONSUELO",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-05",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "CA",
"license": "PSY23668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.