Su Ying Sharon Tan, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22612 Issued in CA

Practice address

544 S Brea Blvd
Brea, CA 92821-5304

Phone

(877) 277-2725

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Quest Health Management Psychological Corporation

  • Community/Behavioral Health Agency
  • Chino, CA
  • NPI 1245791490
  Medicare reassignment
• Cognitive Care Solutions Inc

  • Psychologist
  • Santa Ana, CA
  • NPI 1437583978
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1376677096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2396 BRANCH LN",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214601",
            "telephone_number": "877-277-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 S BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215304",
            "telephone_number": "877-277-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "SU YING",
        "middle_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derick Takeshi Tagawa, DDS
• Irene Taing, PT, DPT
• Heather Takahashi, PT, DPT
• Elena Takounakis
• Alma Tamayo
• Tanaka Family Chiropractic
• Tanya Ward Family Psychotherapy Corporation
• Zoe Alanna Selah Taper
• Alyssah Marie Tapia
• Theresa Araujo Tapia, LMFT

• Clinical Psychologist in Brea, CA
• Providers in Brea, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.