Active NPI
Paul Santero
- Clinical Psychologist
- La Jolla, CA
National Provider Identifier
1003453853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY31003
- Practice address
- 3252 Holiday CT Ste 205
La Jolla, CA 92037-1808 - Phone
- (619) 750-0970
- NPI assigned
- Nov 27, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY31003 | CA | Primary |
Addresses
Primary practice location
3252 Holiday CT Ste 205
La Jolla, CA 92037-1808
Mailing address
4415 Pomona Ave
La Mesa, CA 91942-9118
Phone (619) 507-9294
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3252 Holiday CT
Suite 205
La Jolla, CA 92037-1808
Phone (619) 750-0970
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY31003 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Joseph Psychological Clinic Inc | Clinical | Current | Accepting new patients |
Locations
3252 Holiday Ct
Ste 205
La Jolla, CA 92037
Phone (619) 750-0970
3160 Camino del Rio S
San Diego, CA 92108
Phone (516) 872-7001
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- La Jolla, CA
- NPI 1295373918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574812800000",
"number": "1003453853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4415 POMONA AVE",
"city": "LA MESA",
"state": "CA",
"postal_code": "919429118",
"telephone_number": "619-507-9294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3252 HOLIDAY CT STE 205",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371808",
"telephone_number": "619-750-0970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTERO",
"first_name": "PAUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-27",
"last_updated": "2019-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY31003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.