Individual provider Active NPI

Jo Ellen Elizabeth Eng, PH.D.

  • Clinical Psychologist
  • Santa Barbara, CA
National Provider Identifier
1508197195
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21941 Issued in CA
Practice address
1187 Coast Village Rd
Suite 10 B
Santa Barbara, CA 93108-2737
Phone
(805) 403-8541
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY21941 CA
Adult Development & Aging Psychologist 103TA0700X PSY21941 CA
Cognitive & Behavioral Psychologist 103TB0200X PSY21941 CA
Clinical Psychologist 103TC0700X PSY21941 CA Primary
Counseling Psychologist 103TC1900X PSY21941 CA

Addresses

Primary practice location

1187 Coast Village Rd
Suite 10 B
Santa Barbara, CA 93108-2737

Mailing address

1187 Coast Village Rd
Suite 10 B
Santa Barbara, CA 93108-2737
Phone (805) 403-8541

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
PSY21941CAMDAdult Development & Aging Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1508197195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 COAST VILLAGE RD",
            "address_2": "SUITE 10 B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931082737",
            "telephone_number": "805-403-8541",
            "fax_number": "805-962-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 COAST VILLAGE RD",
            "address_2": "SUITE 10 B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931082737",
            "telephone_number": "805-403-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENG",
        "first_name": "JO ELLEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21941",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY21941",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY21941",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21941",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY21941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.