Active NPI
Courtney Ann Corrado, PSY.D
- Psychologist
- San Quentin, CA
National Provider Identifier
1497092985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY26210
- Practice address
- 1 Main St
San Quentin, CA 94964-1000 - Phone
- (773) 531-4737
- NPI assigned
- Jan 3, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Psychologist | 103T00000X | PSY26210 | CA | Primary |
Addresses
Primary practice location
1 Main St
San Quentin, CA 94964-1000
Mailing address
PO. Box 35
San Quentin, CA 94964
Phone (773) 531-4737
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 |
|---|---|---|---|
| PSY26210 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1497092985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO. BOX 35",
"city": "SAN QUENTIN",
"state": "CA",
"postal_code": "94964",
"telephone_number": "773-531-4737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MAIN ST",
"city": "SAN QUENTIN",
"state": "CA",
"postal_code": "949641000",
"telephone_number": "773-531-4737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORRADO",
"first_name": "COURTNEY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-03",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY26210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Quentin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.