Active NPI
Sally Ann Schwerdtfeger, PH.D.
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1104949619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 8348
- Practice address
- 3368 2ND Ave
Ste D
San Diego, CA 92103-5666 - Phone
- (619) 295-2600
- Fax
- (619) 295-9096
- NPI assigned
- Apr 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 8348 | CA | Primary |
| Prescribing (Medical) Psychologist | 103TP0016X | PSY8348 | CA |
Addresses
Primary practice location
3368 2ND Ave
Ste D
San Diego, CA 92103-5666
Mailing address
1761 Hotel Circle S.
Ste 358
San Diego, CA 92108
Phone (619) 295-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090501000389 | CA | Practitioner - Psychologist Billing Independently | 7517015464 | Practice locations: San Diego, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1761 Hotel S Cir
Suite 358
San Diego, CA 92108-3318
Phone (619) 295-2600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8348 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY 8348 | CA | MD | Clinical Psychologist |
| PSY8348 | CA | MD | Prescribing (Medical) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232668800000",
"number": "1104949619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1761 HOTEL CIRCLE S.",
"address_2": "STE 358",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92108",
"telephone_number": "619-295-2600",
"fax_number": "619-295-9096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3368 2ND AVE",
"address_2": "STE D",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921035666",
"telephone_number": "619-295-2600",
"fax_number": "619-295-9096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHWERDTFEGER",
"first_name": "SALLY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2009-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 8348",
"primary": true
},
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "CA",
"license": "PSY8348",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.