Anneliese Elizabeth Radke, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29952 Issued in CA

Practice address

2875 Middlefield Rd
Palo Alto, CA 94306

Phone

(207) 387-0740

NPI assigned

Sep 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Germaine Lawrence Incorporated

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Arlington, MA
  • NPI 1831300623
  NPD (past)
• Germaine Lawrence, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Arlington, MA
  • NPI 1194884619
  NPD (past)

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1386894335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 FABLE CT",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940435236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 MIDDLEFIELD RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "94306",
            "telephone_number": "207-387-0740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Claremont Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "MA",
            "postal_code": "024765812",
            "country_code": "US",
            "telephone_number": "781-648-6200 x706",
            "fax_number": "781-646-9106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADKE",
        "first_name": "ANNELIESE",
        "middle_name": "ELIZABETH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Rovira Rabulan
• Kendra Cassandra Ractliffe, PH.D.
• Mabel Rada
• Melanie Rada, FNP
• Elizabeth Rader, PHARMD
• Meri Raffetto, RDN
• Julian J. Raffoul, M.D., PH.D.
• Nilima Manudhane Ragavan, M.D.
• Selina Rager
• Priya Raghavan, NBC-HWC

• Clinical Psychologist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.