Active NPI
Edward Antoni Samy, ED.D.
- Counseling Psychologist
- Los Altos, CA
National Provider Identifier
1487685244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY 16428
- Practice address
- 1000 Fremont Ave
Suite 270
Los Altos, CA 94024-6093 - Phone
- (408) 636-6141
- Fax
- (408) 736-7675
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY 16428 | CA | Primary |
Addresses
Primary practice location
1000 Fremont Ave
Suite 270
Los Altos, CA 94024-6093
Mailing address
PO Box 64042
Sunnyvale, CA 94088-4042
Phone (408) 736-7675
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 16428 | CA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487685244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64042",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940884042",
"telephone_number": "408-736-7675",
"fax_number": "408-736-7675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 FREMONT AVE",
"address_2": "SUITE 270",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940246093",
"telephone_number": "408-636-6141",
"fax_number": "408-736-7675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMY",
"first_name": "EDWARD",
"middle_name": "ANTONI",
"name_prefix": "Mr.",
"credential": "ED.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY 16428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Altos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.