Individual provider Active NPI

Sara Lynne Krasner, PSYD

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1104105105
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY33225 Issued in CA
Practice address
795 Willow Rd BLDG 347a
Menlo Park, CA 94025-2539
Phone
(650) 304-4616
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PSY22335 CA
Clinical Psychologist 103TC0700X PSY33225 CA Primary

Addresses

Primary practice location

795 Willow Rd BLDG 347a
Menlo Park, CA 94025-2539

Mailing address

795 Willow Rd BLDG 347a
Menlo Park, CA 94025-2539
Phone (650) 304-4616

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
PSY22335CAMDPsychologist
PSY33225CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1104105105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD BLDG 347A",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-304-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD BLDG 347A",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-304-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNER",
        "first_name": "SARA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22335",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

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