DR. RISA TAKARA (PH.D.) – Psychologist, NPI 1093390387

DR. RISA TAKARA (PH.D.) is a healthcare provider. based in Orem, Utah. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 8772962-2501 (UT). The NPI Number for DR. RISA TAKARA (PH.D.) is 1093390387

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. RISA TAKARA (PH.D.)
NPI
1093390387
Phone
(801) 224-2313
Address
363 E 1200 S
Enumeration Date
17 March 2021
Last Update Date
16 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8012242313
Graduation Year
2013 (13 years ago)
PAC ID
5597174748
Group Practice PAC ID
1355436791
Professional Enrollment ID
I20210429001757
Address ID
UT840586904OR363XX1200301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

236 CLINICAL PSYCHOLOGIST in UT

Provider Addresses for DR. RISA TAKARA (PH.D.)

  • 363 E 1200 S

    OREM, UT 840586904

    Phone: (801) 224-2313

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-04-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210429001757IClinical PsychologistUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 84058)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355436791View full group profile
NameSpecialtyState
Clinical PsychologistUT
Clinical PsychologistUT
Marriage And Family TherapistUT
Mental Health CounselorUT
Clinical PsychologistUT
Clinical PsychologistUT

Reviews

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Frequently asked questions

What identifier follows DR. RISA TAKARA (PH.D.) across health systems?
The NPI 1093390387 uniquely identifies DR. RISA TAKARA (PH.D.) in U.S. healthcare data.
Should I treat DR. RISA TAKARA (PH.D.) as an active provider?
Patients and plans typically see DR. RISA TAKARA (PH.D.) as active in the national extract.
Which specialty label fits DR. RISA TAKARA (PH.D.)?
NPPES ties DR. RISA TAKARA (PH.D.) to Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. RISA TAKARA (PH.D.)?
DR. RISA TAKARA (PH.D.) is associated with Orem, Utah in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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