npidexNPI registry + Medicare data

PRISCILLA HERNANDEZ HACKER, PH.D.

Clinical Psychologist · MOSCOW, ID

Individual Active Opted out of Medicare NPI 1063469203

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Clinical Psychologist103TC0700X✓PSY202196ID
Clinical Psychologist103TC0700XPY1696WA

Medicare eligibility

Part B
Yes
DME
Yes
Home health
No
Power mobility
No
Hospice
No

Opted out of Medicare (Clinical Psychologist), effective 2019-10-01 through 2027-10-01.

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.