Active NPI
Stacy Chiang
- Clinical Psychologist
- San Mateo, CA
National Provider Identifier
1487007936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32586
- Practice address
- 318 S B St Ste 5
San Mateo, CA 94401-4029 - Phone
- (650) 239-6683
- NPI assigned
- Jul 20, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 32586 | CA | Primary |
Addresses
Primary practice location
318 S B St Ste 5
San Mateo, CA 94401-4029
Mailing address
1321 Upland Dr
Houston, TX 77043-4718
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32586 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1487007936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 UPLAND DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770434718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 S B ST STE 5",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944014029",
"telephone_number": "650-239-6683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIANG",
"first_name": "STACY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-20",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.