DR. RANDALL LEE AHN PHD, MLIS - NPI 1093939399

Q: What is Randall Ahn's NPI number?

The NPI number for Randall Ahn is 1093939399. It was assigned to this individual provider in the NPPES registry on April 11, 2007.

Q: What is Randall Ahn's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Randall Ahn was last updated on May 7, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Randall Lee Ahn Phd, Mlis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RANDALL LEE AHN PHD, MLIS (NPI 1093939399) is an individual clinical child & adolescent provider in Fontana, California, licensed in California (PSY13956) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1093939399

Entity TypeIndividualMale

Primary Taxonomy103TC2200X

Provider Legal NameDR. RANDALL LEE AHNCredential: PHD, MLIS

Location Address16465 SIERRA LAKES PKWY STE 140Fontana, CA 92336-1242

Mailing Address241 E 17th St # 1029Costa Mesa, CA 92627-3831 · (949) 414-7149

Phone(909) 244-9593

Fax(833) 903-0337

Sole ProprietorYes

Enumeration DateApril 11, 2007

Last NPPES UpdateMay 7, 20242 updates tracked since enumeration

NPPES CertifiedMay 7, 2024

✔ NPI 1093939399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in CA · PSY13956

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

16465 SIERRA LAKES PKWY STE 140, Fontana, CA 92336

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Secondary Practice Locations 2

Location 13137 Dwight Rd Ste 600Elk Grove, CA 95758-6472 · Phone (909) 244-9593

Location 25201 Great America Pkwy Ste 320Santa Clara, CA 95054-1140 · Phone (323) 205-7088 · Fax (833) 419-0181

Other Identifiers 1

OtherPSY13956CA · Psychology License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Randall Lee Ahn Phd, Mlis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.