Individual provider Active NPI

Eric Terry, PSY.D.

  • Clinical Psychologist
  • Placentia, CA
National Provider Identifier
1992852990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY17277 Issued in CA
Practice address
101 S Kraemer Blvd Ste 236
Placentia, CA 92870-6102
Phone
(562) 619-2571
Fax
(562) 864-8127
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY17277 CA Primary

Addresses

Primary practice location

101 S Kraemer Blvd Ste 236
Placentia, CA 92870-6102

Mailing address

101 S Kraemer Blvd Ste 236
Placentia, CA 92870-6102
Phone (562) 619-2571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081231000420 CA Practitioner - Clinical Psychologist 3870655764 Practice locations: Placentia, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17277CAMDMental Health Counselor
PSY17277CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992852990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S KRAEMER BLVD STE 236",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706102",
            "telephone_number": "562-619-2571",
            "fax_number": "562-864-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S KRAEMER BLVD STE 236",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706102",
            "telephone_number": "562-619-2571",
            "fax_number": "562-864-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.