Individual provider Active NPI

Anna Nedelisky Zeman, PH.D.

  • Clinical Psychologist
  • San Mateo, CA
National Provider Identifier
1265628820
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26298 Issued in CA
Practice address
318 S B St
Ste 5
San Mateo, CA 94401-4029
Phone
(917) 331-1503
Fax
(650) 763-9191
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 017719 NY
Clinical Neuropsychologist 103G00000X 017719 NY
Clinical Neuropsychologist 103G00000X PSY26298 CA
Clinical Psychologist 103TC0700X PSY26298 CA Primary

Addresses

Primary practice location

318 S B St
Ste 5
San Mateo, CA 94401-4029

Mailing address

2104 Hale Dr
Burlingame, CA 94010-5514
Phone (917) 331-1503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2016 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY26298CAMDClinical Neuropsychologist
017719NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1265628820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 HALE DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105514",
            "telephone_number": "917-331-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 S B ST",
            "address_2": "STE 5",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944014029",
            "telephone_number": "917-331-1503",
            "fax_number": "650-763-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDELISKY ZEMAN",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017719",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "017719",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY26298",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.