Unknown Individual – Clinical Psychologist, NPI 1962425744

Unknown Individual is a healthcare provider. based in El verano, California. specializing in Clinical Psychologist. They hold a License No. PSY17130 (CA). The NPI Number for Unknown Individual is 1962425744

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962425744
Phone
(707) 938-5531
Address
PO BOX 134
Deactivation Date
15 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7079385531
Graduation Year
1998 (28 years ago)
PAC ID
9931101227
Professional Enrollment ID
I20070215000774
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

  • PO BOX 134

    EL VERANO, CA 954330134

    Phone: (707) 938-5531

    Fax: (707) 938-5531

    Type: Mailing

  • 19449, Riverside Drive, Park Creek Village Mobile Home Park, El Verano, Sonoma County, California, 95476, United States

    STE 230

    SONOMA, CA 954766361

    Phone: (707) 938-5531

    Fax: (707) 938-5531

    Type: Location

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

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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)

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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 95433)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1962425744 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Clinical Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists El Verano, California for Unknown Individual; download NPPES for the complete set.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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