Active NPI
Ellen Woo, PHD
- Psychologist
- Fresno, CA
National Provider Identifier
1265660112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 22726
- Practice address
- 155 N Fresno St
Fresno, CA 93701-2302 - Phone
- (559) 499-6580
- Fax
- (559) 499-6581
- NPI assigned
- Jun 30, 2009
- Last updated
- May 7, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 22726 | CA | Primary |
| Neurology Physician | 2084N0400X | PSY22726 | CA |
Addresses
Primary practice location
155 N Fresno St
Fresno, CA 93701-2302
Mailing address
155 N Fresno St
Fresno, CA 93701-2302
Phone (559) 499-6580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY227260 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 22726 | CA | MD | Psychologist |
| PSY22726 | CA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557187200000",
"number": "1265660112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 N FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937012302",
"telephone_number": "559-499-6580",
"fax_number": "559-499-6581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 N FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937012302",
"telephone_number": "559-499-6580",
"fax_number": "559-499-6581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOO",
"first_name": "ELLEN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-30",
"last_updated": "2019-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 22726",
"primary": true
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "PSY22726",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY227260",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.