Active NPI
Elaine Stacey McMillan, PH.D.
- Clinical Psychologist
- San Jose, CA
National Provider Identifier
1295054864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23530
- Practice address
- 80 Great Oaks Blvd
San Jose, CA 95119-1310 - Phone
- (408) 363-3000
- NPI assigned
- May 21, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 23530 | CA | Primary |
Addresses
Primary practice location
80 Great Oaks Blvd
San Jose, CA 95119-1310
Mailing address
80 Great Oaks Blvd
San Jose, CA 95119-1310
Phone (408) 363-3000
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 |
|---|---|---|---|
| 23530 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| VA Palo Alto Healthcare System | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- VA Clinic/Center
- San Jose, CA
- NPI 1003206244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1295054864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 GREAT OAKS BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951191310",
"telephone_number": "408-363-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 GREAT OAKS BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951191310",
"telephone_number": "408-363-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLAN",
"first_name": "ELAINE",
"middle_name": "STACEY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-21",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "23530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.