Jennifer Marie Staples, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30218 Issued in CA

Practice address

3737 Camino del Rio S Ste 302
San Diego, CA 92108-4009

Phone

(619) 787-6676

NPI assigned

Aug 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Personal Evolution Psychotherapy, Inc

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1356779482
  NPD (past)

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

{
    "created_epoch": "1533945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533945600000",
    "number": "1295214146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 CAMINO DEL RIO S STE 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 CAMINO DEL RIO S STE 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084009",
            "telephone_number": "619-787-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-11",
        "last_updated": "2018-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Beth Stanton, LCSW
• Mark Paul Stanton, MD
• Lillian Stanwick
• Braden Andrew Stanyer
• Anthony James Stanzi, M.D.
• Lamesha Staples
• Lisa Ann Stapley, RN
• Jean Kay Stapp, PHD
• Star Home Health and Hospice LLC
• Star Hospice LLC

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2018; 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.