Individual provider Active NPI

Joanna Andrea Pashdag, PHD

  • Psychologist
  • Petaluma, CA
National Provider Identifier
1508070731
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 20988 Issued in CA
Practice address
7 4TH St
Suite 13
Petaluma, CA 94952-3043
Phone
(707) 364-2207
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 20988 CA Primary

Addresses

Primary practice location

7 4TH St
Suite 13
Petaluma, CA 94952-3043

Mailing address

7 4TH St
Suite 13
Petaluma, CA 94952-3043
Phone (707) 364-2207

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 20988CAMDPsychologist
20988CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1508070731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 4TH ST",
            "address_2": "SUITE 13",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523043",
            "telephone_number": "707-364-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 4TH ST",
            "address_2": "SUITE 13",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523043",
            "telephone_number": "707-364-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASHDAG",
        "first_name": "JOANNA",
        "middle_name": "ANDREA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 20988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.