Individual provider Active NPI

Jennifer Stelle Guittard, PH.D

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1407509078
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31991 Issued in CA
Practice address
1939 Divisadero St Ste 1
San Francisco, CA 94115-2507
Phone
(415) 915-2334
NPI assigned
Feb 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY31991 CA Primary

Addresses

Primary practice location

1939 Divisadero St Ste 1
San Francisco, CA 94115-2507

Mailing address

10 Guittard Rd
Burlingame, CA 94010-2203
Phone (415) 915-2334

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY31991CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1407509078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GUITTARD RD",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940102203",
            "telephone_number": "415-915-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 DIVISADERO ST STE 1",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152507",
            "telephone_number": "415-915-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUITTARD",
        "first_name": "JENNIFER",
        "middle_name": "STELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31991",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 2, 2022; 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.