Active NPI
Shi-Ming Peggy Chin-Ortiz, PSY.D.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1447565452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23690
- Practice address
- 842 California St
San Francisco, CA 94108-2315 - Phone
- (415) 869-2895
- NPI assigned
- Aug 13, 2010
- Sex
- Female
- 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 | 23690 | CA | Primary |
Addresses
Primary practice location
842 California St
San Francisco, CA 94108-2315
Mailing address
235 Westlake Ctr
#425
Daly City, CA 94015-1430
Phone (415) 869-2895
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110309000305 | CA | Practitioner - Clinical Psychologist | 6103008370 | Practice locations: Daly City, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
550 Washington St
Suite 112
Daly City, CA 94015-1929
Phone (415) 869-2895
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23690 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1447565452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 WESTLAKE CTR",
"address_2": "#425",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940151430",
"telephone_number": "415-869-2895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "842 CALIFORNIA ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941082315",
"telephone_number": "415-869-2895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN-ORTIZ",
"first_name": "SHI-MING",
"middle_name": "PEGGY",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-13",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "23690",
"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 Aug 28, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.