Active NPI
Nasreen Yadao, PSYD
- Case Manager/Care Coordinator
- Fairfield, CA
National Provider Identifier
1124470216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 2460 Clay Bank Rd
Fairfield, CA 94533-1655 - Phone
- (707) 399-4834
- NPI assigned
- Jul 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | 327217 | ZZ | |
| Clinical Psychologist | 103TC0700X | 94026407 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | ||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
2460 Clay Bank Rd
Fairfield, CA 94533-1655
Mailing address
2460 Clay Bank Rd
Fairfield, CA 94533-1655
Phone (707) 399-4834
Other practice location 1
1959 Solano Way
Concord, CA 94520
Phone (925) 676-9768
Other practice location 2
1850 Gateway Blvd Ste 900
Concord, CA 94520-8418
Phone (925) 825-4700
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
| License | State | Type | Specialty |
|---|---|---|---|
| 94026407 | CA | MD | Clinical Psychologist |
| 327217 | ZZ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1124470216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 CLAY BANK RD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945331655",
"telephone_number": "707-399-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2460 CLAY BANK RD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945331655",
"telephone_number": "707-399-4834"
}
],
"practiceLocations": [
{
"address_1": "1959 Solano Way",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "CA",
"postal_code": "94520",
"country_code": "US",
"telephone_number": "925-676-9768",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1850 Gateway Blvd Ste 900",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "CA",
"postal_code": "945208418",
"country_code": "US",
"telephone_number": "925-825-4700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YADAO",
"first_name": "NASREEN",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-13",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ZZ",
"license": "327217",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "94026407",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.