MEDICARE: COGNITIVE INSIGHT INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1396698015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COGNITIVE INSIGHT INC

Provider Business Mailing Address
First Line	:	PO BOX 721634
Second Line	:
City	:	PINON HILLS
State	:	CA
Zip	:	92372-1634
Country	:	US
Telephone Number	:	562-291-7887
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 MARCOS RD
Second Line	:
City	:	PINON HILLS
State	:	CA
Zip	:	92372
Country	:	US
Telephone Number	:	562-291-7887
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CRYSTAL MONIQUE ANKELE
Credential	:	PSYD
Telephone Number	:	562-291-7887

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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