Individual provider Active NPI

Emma Porterfield Michalopoulos, PSY.D

  • Clinical Child & Adolescent Psychologist
  • San Diego, CA
National Provider Identifier
1366835217
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY29509 Issued in CA
Practice address
2555 Camino del Rio S
Suite 208
San Diego, CA 92108-3704
Phone
(619) 630-4642
Fax
(877) 619-0823
NPI assigned
Mar 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY29509 CA Primary

Addresses

Primary practice location

2555 Camino del Rio S
Suite 208
San Diego, CA 92108-3704

Mailing address

2555 Camino del Rio S
Suite 208
San Diego, CA 92108-3704
Phone (619) 630-4642

Other names 1

  • Dr. Emma Arlene Porterfield Former name

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
PSY29509CAMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1366835217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 CAMINO DEL RIO S",
            "address_2": "SUITE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083704",
            "telephone_number": "619-630-4642",
            "fax_number": "877-619-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 CAMINO DEL RIO S",
            "address_2": "SUITE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083704",
            "telephone_number": "619-630-4642",
            "fax_number": "877-619-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALOPOULOS",
        "first_name": "EMMA",
        "middle_name": "PORTERFIELD",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2024-08-05",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY29509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "PORTERFIELD",
            "middle_name": "ARLENE",
            "prefix": "DR.",
            "credential": "PSY.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.