Unknown Individual – Clinical Psychologist, NPI 1235100421

Unknown Individual is a healthcare provider. based in Long beach, California. specializing in Clinical Psychologist. They hold a License No. PSY7752 (CA). The NPI Number for Unknown Individual is 1235100421

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1235100421
Phone
(562) 597-3673
Address
5199 E PACIFIC COAST HWY
Deactivation Date
17 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
56259736731
Graduation Year
1981 (45 years ago)
PAC ID
2365628617
Professional Enrollment ID
I20110520000409
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

  • Pacific Coast Highway, Seal Beach, Orange County, California, 90743, United States

    STE 304

    LONG BEACH, CA 90804

    Phone: (562) 597-3673

    Fax: (562) 597-5083

    Type: Location

  • Pacific Coast Highway, Long Beach, Los Angeles County, California, 90810, United States

    STE 304

    LONG BEACH, CA 90804

    Phone: (562) 597-3673

    Fax: (562) 597-5083

    Type: Mailing

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.

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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.

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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 90804)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1235100421; it appears in the national provider directory.
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 Long Beach, California for Unknown Individual; expand the address list for detail.
What if Long Beach, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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