Annelie S Purdy PHD Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY5452 Issued in CA

Legal business name

ANNELIE S PURDY PHD INC

Practice address

433 So Lincoln Street
Annelie S Purdy PHD Inc
Santa Maria, CA 93458

Phone

(805) 349-9706

Fax

(805) 349-0576

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Annelie S Purdy, PHDNPI 1982675930

Title

Psychologist

Phone

(805) 349-9706

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Annelie S Purdy PhD Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Annelie S. Purdy, PH.D.

  • Clinical Psychologist
  • Santa Maria, CA
  • NPI 1982675930
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1336327071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 SOUTH LINCOLN STREET",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93458",
            "telephone_number": "805-349-9706",
            "fax_number": "805-349-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SO LINCOLN STREET",
            "address_2": "ANNELIE S PURDY PHD INC",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93458",
            "telephone_number": "805-349-9706",
            "fax_number": "805-349-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNELIE S PURDY PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "PURDY",
        "authorized_official_first_name": "ANNELIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "805-349-9706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY5452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00PL54520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTION",
            "identifier": "151010",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD UBH",
            "identifier": "6128337",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Annelie S Purdy PhD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.