Active NPI
Neil A Hersh, PH.D.
- Clinical Psychologist
- San Mateo, CA
National Provider Identifier
1023448099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 7728
- Practice address
- 111 Saint Matthews Ave
# 208
San Mateo, CA 94401-2851 - Phone
- (650) 483-5674
- NPI assigned
- Nov 12, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY 7728 | CA | |
| Clinical Psychologist | 103TC0700X | PSY 7728 | CA | Primary |
Addresses
Primary practice location
111 Saint Matthews Ave
# 208
San Mateo, CA 94401-2851
Mailing address
111 Saint Matthews Ave
Unit 208
San Mateo, CA 94401-2851
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 7728 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384214400000",
"number": "1023448099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 SAINT MATTHEWS AVE",
"address_2": "UNIT 208",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944012851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SAINT MATTHEWS AVE",
"address_2": "# 208",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944012851",
"telephone_number": "650-483-5674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSH",
"first_name": "NEIL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-12",
"last_updated": "2013-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY 7728",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 7728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.