Active NPI
Simone Madan, PHD
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1205086865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY16433
- Practice address
- 1701 Divisadero St
5TH Floor
San Francisco, CA 94143-1731 - Phone
- (415) 353-7300
- NPI assigned
- Sep 19, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY16433 | CA | Primary |
Addresses
Primary practice location
1701 Divisadero St
5TH Floor
San Francisco, CA 94143-1731
Mailing address
1701 Divisadero St
5TH Floor
San Francisco, CA 94143-1731
Phone (415) 353-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16433 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221782400000",
"number": "1205086865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 DIVISADERO ST",
"address_2": "5TH FLOOR",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941431731",
"telephone_number": "415-353-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 DIVISADERO ST",
"address_2": "5TH FLOOR",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941431731",
"telephone_number": "415-353-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADAN",
"first_name": "SIMONE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-19",
"last_updated": "2008-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY16433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.