Individual provider Active NPI

Karen Lynette Schwarz Danylchuk, PH.D.

  • Clinical Psychologist
  • San Mateo, CA
National Provider Identifier
1124179155
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13668 Issued in CA
Practice address
4 W 4TH Ave
Ste B
San Mateo, CA 94402-1619
Phone
(650) 773-4476
Fax
(650) 349-3255
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 PSY13668 CA Primary

Addresses

Primary practice location

4 W 4TH Ave
Ste B
San Mateo, CA 94402-1619

Mailing address

4 W 4TH Ave
Ste B
San Mateo, CA 94402-1616
Phone (650) 773-4476

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13668CAMDClinical Psychologist
13668CAMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124179155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W 4TH AVE",
            "address_2": "STE B",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021616",
            "telephone_number": "650-773-4476",
            "fax_number": "650-349-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W 4TH AVE",
            "address_2": "STE B",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021619",
            "telephone_number": "650-773-4476",
            "fax_number": "650-349-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANYLCHUK",
        "first_name": "KAREN",
        "middle_name": "LYNETTE SCHWARZ",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.