Individual provider Active NPI

Gabrielle Lou, PSYD

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1154638906
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28231 Issued in CA
Practice address
1040 Noel Dr
Menlo Park, CA 94025-3358
Phone
(650) 815-8256
NPI assigned
Aug 31, 2010
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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 PSY28231 CA Primary

Addresses

Primary practice location

1040 Noel Dr
Menlo Park, CA 94025-3358

Mailing address

PO Box 302
Menlo Park, CA 94026-0302
Phone (650) 815-8256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405000525 CA Practitioner - Clinical Psychologist 9739465816 Practice locations: Menlo Park, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1040 Noel Dr
Suite 106
Menlo Park, CA 94025-3357
Phone (650) 815-8256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28231CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1154638906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 302",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940260302",
            "telephone_number": "650-815-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NOEL DR",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253358",
            "telephone_number": "650-815-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOU",
        "first_name": "GABRIELLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2010-08-31",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.