Richard Ettelson, PHD - Medicare Psychologist in Rancho Cucamonga, CA

Richard Ettelson, PHD is a medicare enrolled "Psychologist - Clinical" provider in Rancho Cucamonga, California. His current practice location is 10630 Town Center Dr Ste 120, Rancho Cucamonga, California. You can reach out to his office (for appointments etc.) via phone at (909) 989-0901.

Richard Ettelson is licensed to practice in California (license number D5418953) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1174569453.

Contact Information

Richard Ettelson, PHD
10630 Town Center Dr Ste 120,
Rancho Cucamonga, CA 91730-6889
(909) 989-0901
(909) 941-1087



Healthcare Provider's Profile

Full NameRichard Ettelson
GenderMale
SpecialityPsychologist - Clinical
Location10630 Town Center Dr Ste 120, Rancho Cucamonga, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1174569453
  • Provider Enumeration Date: 06/22/2006
  • Last Update Date: 09/18/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 6507298080
  • Enrollment ID: I20191121002304

Medical Identifiers

Medical identifiers for Richard Ettelson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174569453NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical D5418953 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Richard Ettelson allows following entities to bill medicare on his behalf.
Entity NameMemory Check Psychological Services, A Professional Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912184219
PECOS PAC ID: 7416856422
Enrollment ID: O20040107001021

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Richard Ettelson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Richard Ettelson, PHD
10630 Town Center Dr Ste 120,
Rancho Cucamonga, CA 91730-6889

Ph: (909) 989-0901
Richard Ettelson, PHD
10630 Town Center Dr Ste 120,
Rancho Cucamonga, CA 91730-6889

Ph: (909) 989-0901

News Archive

Critical Diagnostics receives FDA clearance for Presage ST2 Assay

Critical Diagnostics, a U.S.-based biomarker company focused on cardiovascular diseases, announced today that the U.S. Food and Drug Administration has cleared the company's Presage ST2 Assay for use as an aid in assessing the prognosis of patients diagnosed with chronic heart failure.

UT candidate wins AHA fellowship to support research in cardiovascular, stroke discoveries

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Psychologist in Rancho Cucamonga, CA

Dr. Lauri Lee Rogers, PSY.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 9089 Baseline Rd, Suite 200, Rancho Cucamonga, CA 91730
Phone: 909-980-3567    Fax: 909-989-3932
Victor Cordova, PSY.D
Psychologist
Medicare: Medicare Enrolled
Practice Location: 9033 Base Line Rd Ste A, Rancho Cucamonga, CA 91730
Phone: 909-922-2442    Fax: 909-999-2377
Dr. Scott Su, PHD
Psychologist
Medicare: Accepting Medicare Assignments
Practice Location: 8300 Utica Ave Ste 245, Rancho Cucamonga, CA 91730
Phone: 909-247-5992    
Dr. Krystle Rose Frazier-philo, ED.D.
Psychologist
Medicare: Medicare Enrolled
Practice Location: 9600 Center Ave Ste 160, Rancho Cucamonga, CA 91730
Phone: 800-434-8923    
Veronica Nakla,
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 9377 Haven Ave Ste 100, Rancho Cucamonga, CA 91730
Phone: 909-906-1505    
Dr. Stacey Waring, PSY.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739
Phone: 909-463-5179    
Dr. Jerry M Goffman, PHD.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 8253 White Oak Ave, Rancho Cucamonga, CA 91730
Phone: 951-312-1041    

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