Steffani Lorraine Kizziar, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3745 Issued in OR

Practice address

698 12TH St SE Ste 145
Salem, OR 97301-4076

Phone

(415) 847-0746

Fax

(415) 847-0746

NPI assigned

Jun 12, 2017

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 OR

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

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.

• Larsen Sanchez Psychology, LLC

  dba Portland Mental Health & Wellness

  • Clinical Psychologist
  • Portland, OR
  • NPI 1588041388
  Medicare reassignment
• Diagnostic Imaging Associates Inc

  dba Diagnostic Imaging Of Salem

  • Diagnostic Radiology Physician
  • Salem, OR
  • NPI 1356408215
  NPD (past)

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1437688553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 JUDSON ST S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025309",
            "telephone_number": "415-847-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 12TH ST SE STE 145",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014076",
            "telephone_number": "415-847-0746",
            "fax_number": "415-847-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZZIAR",
        "first_name": "STEFFANI",
        "middle_name": "LORRAINE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darcey Kirkwood, LCSW
• Dorian Kirrigan
• Patrick Kirsch, THW
• Jonathan Kiser
• Rachel Shannon Kitterman
• Audrey Klampe
• Gretchen Klampe
• Haley Klann
• Carley Klein-Peters
• Meredith R. Klein, CPM, LDM

• Clinical Psychologist in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.