Individual provider Active NPI

Diagou Regina Sissoko, PHD

  • Clinical Psychologist
  • Bronx, NY
National Provider Identifier
1215801998
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810009007 Issued in VA
Practice address
1307 Edward L Grant Hwy Apt 5H
Bronx, NY 10452-3151
Phone
(646) 250-3845
NPI assigned
Oct 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 0810009007 VA Primary

Addresses

Primary practice location

1307 Edward L Grant Hwy Apt 5H
Bronx, NY 10452-3151

Mailing address

1307 Edward L Grant Hwy Apt 5H
Bronx, NY 10452-3151
Phone (646) 250-3845

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
0810009007VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1759449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1215801998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 EDWARD L GRANT HWY APT 5H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523151",
            "telephone_number": "646-250-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 EDWARD L GRANT HWY APT 5H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523151",
            "telephone_number": "646-250-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSOKO",
        "first_name": "DIAGOU",
        "middle_name": "REGINA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-03",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810009007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.