Active NPI
Jonathan James Yip, PHD
- Clinical Psychologist
- Elk Grove, CA
National Provider Identifier
1235435082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25986
- Practice address
- 8220 Longleaf Dr
Elk Grove, CA 95758-1322 - Phone
- (209) 450-5614
- NPI assigned
- Jan 26, 2011
- Sex
- Male
- 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 | 25986 | CA | Primary |
Addresses
Primary practice location
8220 Longleaf Dr
Elk Grove, CA 95758-1322
Mailing address
8220 Longleaf Dr
Elk Grove, CA 95758-1322
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 |
|---|---|---|---|
| 25986 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1235435082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8220 LONGLEAF DR",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957581322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8220 LONGLEAF DR",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957581322",
"telephone_number": "209-450-5614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YIP",
"first_name": "JONATHAN",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-26",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "25986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.