Active NPI
Shokooh Miry, PSYD
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1396026381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 24343
- Practice address
- 1 Sansome St FL 35
San Francisco, CA 94104-4436 - Phone
- (415) 298-0122
- NPI assigned
- Sep 2, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 24343 | CA | Primary |
Addresses
Primary practice location
1 Sansome St FL 35
San Francisco, CA 94104-4436
Mailing address
1 Sansome St FL 35
San Francisco, CA 94104-4436
Phone (415) 298-0122
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24343 | Other | CA | BOARD OF PSYCHOLOGY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24343 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1396026381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SANSOME ST FL 35",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941044436",
"telephone_number": "415-298-0122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SANSOME ST FL 35",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941044436",
"telephone_number": "415-298-0122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRY",
"first_name": "SHOKOOH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-02",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "24343",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PSYCHOLOGY LICENSE",
"identifier": "24343",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.