Individual provider Active NPI

Amber Haydu, PSY.D.

  • Psychologist
  • Vacaville, CA
National Provider Identifier
1043628092
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY33403 Issued in CA
Practice address
2100 Peabody Rd
Vacaville, CA 95687-6639
Phone
(707) 451-0182
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY33403 CA Primary

Addresses

Primary practice location

2100 Peabody Rd
Vacaville, CA 95687-6639

Mailing address

2100 Peabody Rd
Vacaville, CA 95687-6639
Phone (707) 451-0182

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
PSY33403CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters CurrentSince Jul 3, 2022 Accepting new patients
State of California Prison Industry Authority PastSince Jul 3, 2022 Accepting new patients

Locations

2100 Peabody Rd
Vacaville, CA 95687
Phone (707) 451-0182

Organizations & group practices 2

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1043628092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PEABODY RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956876639",
            "telephone_number": "707-451-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PEABODY RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956876639",
            "telephone_number": "707-451-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDU",
        "first_name": "AMBER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.