CARISSA MARIE DOUGLAS PSYD
NPI 1508052986
Psychologist - Clinical in Murrieta, CA
About Carissa Marie Douglas Psyd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARISSA MARIE DOUGLAS PSYD (NPI 1508052986) is an individual clinical provider in Murrieta, California, licensed in California (32327) and active in the NPI registry since September 2007. She has opted out of Medicare through April 19, 2028 and remains eligible to order and refer and maintains a secondary practice location in Pasadena.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Carissa Marie Douglas Psyd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 19, 2022 through April 19, 2028.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92562 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MURRIETA, CA 92562
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Carissa Douglas's NPI number?
The NPI number for Carissa Douglas is 1508052986. It was assigned to this individual provider in the NPPES registry on September 19, 2007.
Where is Carissa Douglas located?
Carissa Douglas practices at 41197 Golden Gate Cir Ste 206, Murrieta, CA 92562. The listed phone number is (951) 394-3227.
What is Carissa Douglas's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Carissa Douglas enrolled in Medicare?
No. Carissa Douglas has opted out of Medicare through April 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Carissa Douglas was last updated on February 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Carissa Marie Douglas, PSYD · NPI 1508052986
Clinical provider in Murrieta, California. Individual provider, active in the CMS NPPES registry since September 19, 2007.
## Identity
- **NPI:** 1508052986 (Entity type: Individual)
- **Enumerated:** September 19, 2007
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 32327 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 41197 GOLDEN GATE CIR STE 206, Murrieta, CA 92562-6999
- **Phone:** (951) 394-3227
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 19, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** February 5, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1508052986) · Data from the CMS NPPES public registry.