Individual provider Active NPI

William Hayward Staso, PHD

  • Psychologist
  • Roseville, CA
National Provider Identifier
1477918654
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY8118 Issued in CA
Practice address
2137 Rhodes LN
Roseville, CA 95747-9024
Phone
(916) 899-2638
NPI assigned
Dec 15, 2015
Last updated
Dec 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY8118 CA Primary

Addresses

Primary practice location

2137 Rhodes LN
Roseville, CA 95747-9024

Mailing address

2137 Rhodes LN
Roseville, CA 95747-9024
Phone (916) 899-2638

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
PSY8118CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1477918654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 RHODES LN",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957479024",
            "telephone_number": "916-899-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 RHODES LN",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957479024",
            "telephone_number": "916-899-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASO",
        "first_name": "WILLIAM",
        "middle_name": "HAYWARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.