Individual provider Active NPI

Emily Irene Lepage-Wu, M.S., LEP, ABSNP

  • School Psychologist
  • San Mateo, CA
National Provider Identifier
1033827225
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
3859 Issued in CA
Practice address
760 Polhemus Rd
San Mateo, CA 94402-3938
Phone
(650) 349-8717
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 3859 CA Primary

Addresses

Primary practice location

760 Polhemus Rd
San Mateo, CA 94402-3938

Mailing address

PO Box 384
San Carlos, CA 94070-0384
Phone (650) 394-6021

Other practice location 1

388 De Anza Ave
San Carlos, CA 94070-4433
Phone (650) 394-6021

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
Master of Science

State licenses

LicenseStateTypeSpecialty
3859CAMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Associates Speech Therapy Services, Inc. CurrentSince Apr 1, 2023 Accepting new patients

Locations

760 Polhemus Rd
San Mateo, CA 94402
Phone (650) 349-8717

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.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1033827225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 384",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940700384",
            "telephone_number": "650-394-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 POLHEMUS RD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023938",
            "telephone_number": "650-349-8717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "388 De Anza Ave",
            "address_purpose": "LOCATION",
            "city": "San Carlos",
            "state": "CA",
            "postal_code": "940704433",
            "country_code": "US",
            "telephone_number": "650-394-6021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEPAGE-WU",
        "first_name": "EMILY",
        "middle_name": "IRENE",
        "credential": "M.S., LEP, ABSNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "3859",
            "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 7, 2022; 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.