Active NPI
Tay K Sandoz, PSY.D.
- Clinical Psychologist
- Irvine, CA
National Provider Identifier
1396766416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 15847
- Practice address
- 2151 Michelson Dr Ste 239
Irvine, CA 92612-1343 - Phone
- (949) 862-5818
- NPI assigned
- Jul 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | PSY 15847 | CA | Primary |
Addresses
Primary practice location
2151 Michelson Dr Ste 239
Irvine, CA 92612-1343
Mailing address
2151 Michelson Dr Ste 239
Irvine, CA 92612-1343
Phone (949) 862-5818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY158470 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 15847 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1396766416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2151 MICHELSON DR STE 239",
"city": "IRVINE",
"state": "CA",
"postal_code": "926121343",
"telephone_number": "949-862-5818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 MICHELSON DR STE 239",
"city": "IRVINE",
"state": "CA",
"postal_code": "926121343",
"telephone_number": "949-862-5818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOZ",
"first_name": "TAY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 15847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY158470",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.