Individual provider Active NPI

Paulette Marie Romain-Stave, PSY.D.

  • Clinical Psychologist
  • Hawaiian Gardens, CA
National Provider Identifier
1043349889
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY18624 Issued in CA
Practice address
21520 Pioneer Blvd
Suite 110
Hawaiian Gardens, CA 90716-2603
Phone
(562) 865-3644
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY18624 CA Primary

Addresses

Primary practice location

21520 Pioneer Blvd
Suite 110
Hawaiian Gardens, CA 90716-2603

Mailing address

21520 Pioneer Blvd Ste 110
Hawaiian Gardens, CA 90716-2603

Other names 1

  • Dr. Paulette Marie Romain Former name

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

State licenses

LicenseStateTypeSpecialty
PSY18624CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043349889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21520 PIONEER BLVD STE 110",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907162603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21520 PIONEER BLVD",
            "address_2": "SUITE 110",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907162603",
            "telephone_number": "562-865-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAIN-STAVE",
        "first_name": "PAULETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULETTE",
            "last_name": "ROMAIN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hawaiian Gardens, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.