Natalie Poursohrab Wager, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY29282 Issued in CA

Practice address

725 Welch Rd
Palo Alto, CA 94304-1601

Phone

(650) 497-8000

NPI assigned

Jul 9, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Natelie Poursohrab Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1033631320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "595 Price Ave",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940631464",
            "country_code": "US",
            "telephone_number": "650-322-5910 x112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGER",
        "first_name": "NATALIE",
        "middle_name": "POURSOHRAB",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "29282",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY29282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATELIE",
            "last_name": "POURSOHRAB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Richard Thue Wacker, O.D.
• Anne Elizabeth Waddle
• Natasha Wade, DNP-FNP
• Rachna Gurjeet Wadia, MD
• Kathleen Waeldner
• Connor Spellman Wagner, MD
• Jenny Fox-Manaster Wagner, OT
• Mary June Asenathe Wagner, D.D.S.
• Dina Salwa Wahbe, NP
• Jennifer Wahleithner, PSYD

• Psychologist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.