Individual provider Active NPI

Chantel M. Ulfig, PH.D.

  • Clinical Psychologist
  • Palo Alto, CA
National Provider Identifier
1124789029
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33109 Issued in CA
Practice address
3801 Miranda Ave
Psychology Service (116B)
Palo Alto, CA 94304
Phone
(650) 493-5000
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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 33109 CA Primary

Addresses

Primary practice location

3801 Miranda Ave
Psychology Service (116B)
Palo Alto, CA 94304

Mailing address

3801 Miranda Ave
Psychology Service (116B)
Palo Alto, CA 94304
Phone (650) 493-5000

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33109CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1124789029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "address_2": "PSYCHOLOGY SERVICE (116B)",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "94304",
            "telephone_number": "650-493-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "address_2": "PSYCHOLOGY SERVICE (116B)",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "94304",
            "telephone_number": "650-493-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULFIG",
        "first_name": "CHANTEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.