Active NPI
Sandra Kay Randall, PHD PSYCHOLOGIST
- Psychologist
- Pasadena, CA
National Provider Identifier
1174705925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 17542
- Practice address
- 30 N Raymond Ave
#201
Pasadena, CA 91103 - Phone
- (626) 577-7711
- Fax
- (626) 577-7734
- NPI assigned
- Dec 4, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 17542 | CA | Primary |
Addresses
Primary practice location
30 N Raymond Ave
#201
Pasadena, CA 91103
Mailing address
30 N Raymond Ave
#201
Pasadena, CA 91103
Phone (626) 577-7711
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17542 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1174705925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N RAYMOND AVE",
"address_2": "#201",
"city": "PASADENA",
"state": "CA",
"postal_code": "91103",
"telephone_number": "626-577-7711",
"fax_number": "626-577-7734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N RAYMOND AVE",
"address_2": "#201",
"city": "PASADENA",
"state": "CA",
"postal_code": "91103",
"telephone_number": "626-577-7711",
"fax_number": "626-577-7734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "SANDRA",
"middle_name": "KAY",
"name_prefix": "Dr.",
"credential": "PHD PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "17542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.