Sarah Joy Park, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27418 Issued in CA

Practice address

11605 Cardelina LN
Atascadero, CA 93422-6042

Phone

(626) 806-2009

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 23, 2024 through Jul 23, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Thrive San Luis Obispo

  • Mental Health Counselor
  • San Luis Obispo, CA
  • NPI 1922777069
  NPD Authorized official

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1063969921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 CARDELINA LN",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934226042",
            "telephone_number": "626-806-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11605 CARDELINA LN",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934226042",
            "telephone_number": "626-806-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SARAH",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yamile Palomares Villalobos
• Jason Pambrun, D.D.S.
• Selena Pantoja Reyes
• Paradise Valley Care
• Merry Carol Parente, N.P.
• Kevin Kenneth Parzych, M.D.
• Paso Robles Physical Therapy Inc
• Patrice Peterson-Read
• Patterson and Tedford Pediatrics, a California Medical Corp
• Brian D. Patterson, M.D.

• Clinical Psychologist in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.