Active NPI
Elliott Isenberg, PH.D.
- Psychologist
- San Francisco, CA
National Provider Identifier
1003838079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY11202
- Practice address
- 115 San Jose Ave Apt 4
San Francisco, CA 94110-3052 - Phone
- (415) 695-0499
- NPI assigned
- Jul 25, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY11202 | CA | Primary |
Addresses
Primary practice location
115 San Jose Ave Apt 4
San Francisco, CA 94110-3052
Mailing address
115 San Jose Ave Apt 4
San Francisco, CA 94110-3052
Phone (415) 695-0499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY112020 | Medicaid | CA |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090915000793 | CA | Practitioner - Clinical Psychologist | 7315093481 | Practice locations: San Francisco, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
115 San Jose Ave
San Francisco, CA 94110-3052
Phone (415) 425-6096
115 San Jose Ave Apt
Suite 4
San Francisco, CA 94110-3052
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11202 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354060800000",
"number": "1003838079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 SAN JOSE AVE APT 4",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941103052",
"telephone_number": "415-695-0499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 SAN JOSE AVE APT 4",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941103052",
"telephone_number": "415-695-0499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISENBERG",
"first_name": "ELLIOTT",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2012-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY11202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY112020",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.