Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1932250057 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Louis Randolph , PhD

Psychologist - Clinical • Jackson, CA

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Randolph has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 16, 2007
NPI Deactivation Date May 18, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Randolph, PhD was a registered Psychologist - Clinical practicing in Jackson, CA. Throughout an active medical career spanning 11 years, Dr. Randolph provided care at the practice location at 320 COURT ST until profile deactivation on 2018-05-18.

Practice Location & Contact Primary Location

Practice Address

320 Court St
Ste. 3

Jackson, CA 956422106

Telephone 2092231151
Fax 2092232443

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Jackson, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 3.0 Yrs
State Avg: 23.9 Yrs
Regional Practice Density
3 Specialists

Practicing in Jackson, CA (13237 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License CA PSY9893

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Ellen Beegel , MFT

Marriage & Family Therapist

NPI 1952472565

Marriage and Family Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 18, 2018

Record deactivated on May 18, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 320 COURT ST, STE. 3, JACKSON, CA 956422106 (Tel: 2092231151)

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Updated Business Mailing Address July 08, 2007

Registered at 4806 DONYA DR, MOKELUMNE HILL, CA 952459693 (Tel: 2092861190)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT RANDOLPH, PH.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #PSY9893 in CA)

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Initial NPI Registration & Enumeration January 16, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1932250057
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 16, 2007
Last Update: July 08, 2007
Deactivation Date: May 18, 2018

Mailing Address

4806 Donya Dr

Mokelumne Hill, CA 952459693

Phone: 2092861190

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.