Unknown Individual – Clinical Psychologist, NPI 1023001054

Unknown Individual is a healthcare provider. based in Huntington beach, California. specializing in Clinical Psychologist. They hold a License No. PSY 10209 (CA). The NPI Number for Unknown Individual is 1023001054

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023001054
Phone
(714) 842-7060
Address
16152 BEACH BLVD
Deactivation Date
5 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7148427060
Graduation Year
1985 (41 years ago)
PAC ID
9537352273
Professional Enrollment ID
I20101026000667
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Huntington Beach, Huntington, Suffolk County, New York, United States

    HUNTINGTON BEACH, CA 926473868

    Phone: (714) 842-7060

    Fax: (714) 965-6220

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92647)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1023001054.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Huntington Beach, California for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1023001054. Always confirm identity and privileges with the practice and licensing boards.

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