Individual provider Active NPI

Daniela V Carollo

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1245430669
Registry record updated Aug 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
26115 Issued in CA
Practice address
459 Fulton St
Suite 102
San Francisco, CA 94102-4318
Phone
(415) 562-5596
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Psychologist 103TC0700X 26115 CA Primary

Addresses

Primary practice location

459 Fulton St
Suite 102
San Francisco, CA 94102-4318

Mailing address

1085 S Van Ness Ave Apt 305
San Francisco, CA 94110-2695
Phone (415) 850-8444

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
26115CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408838400000",
    "number": "1245430669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 S VAN NESS AVE APT 305",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102695",
            "telephone_number": "415-850-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 FULTON ST",
            "address_2": "SUITE 102",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941024318",
            "telephone_number": "415-562-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROLLO",
        "first_name": "DANIELA",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2014-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "26115",
            "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 Aug 24, 2014; 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.