Individual provider Active NPI

Justin John Hupalo, AMFT

  • Clinical Psychologist
  • Pleasant Hill, CA
National Provider Identifier
1356052773
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
125867 Issued in CA
Practice address
2400 Lisa LN
Pleasant Hill, CA 94523-3993
Phone
(510) 846-1850
NPI assigned
Dec 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 125867 CA Primary

Addresses

Primary practice location

2400 Lisa LN
Pleasant Hill, CA 94523-3993

Mailing address

1108 Fountain St
Alameda, CA 94501-5548
Phone (510) 388-4242

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address justinhupalo@fredfinch.org Direct Fred Finch Youth CTR.

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

State licenses

LicenseStateTypeSpecialty
125867CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1356052773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 FOUNTAIN ST",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945015548",
            "telephone_number": "510-388-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LISA LN",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945233993",
            "telephone_number": "510-846-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPALO",
        "first_name": "JUSTIN",
        "middle_name": "JOHN",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "125867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justinhupalo@fredfinch.org",
            "affiliation": "Y",
            "endpointDescription": "e-mail address",
            "affiliationName": "Fred Finch Youth CTR.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3800 Coolidge Ave.",
            "address_2": "Building H",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pleasant Hill, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.