Emily Koel, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 14459 Issued in CA

Practice address

1425 Broadway
Suite #22
Burlingame, CA 94010-3458

Phone

(650) 375-0452

Fax

(650) 342-8622

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Service Agency of San Mateo County

  • Social Worker
  • San Mateo, CA
  • NPI 1447423637
  NPD (past)
• Family Service Agency of San Mateo County

  • Clinical Social Worker
  • Redwood City, CA
  • NPI 1669406815
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508872078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 BROADWAY",
            "address_2": "SUITE #22",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103458",
            "telephone_number": "650-375-0452",
            "fax_number": "650-342-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BROADWAY",
            "address_2": "SUITE #22",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103458",
            "telephone_number": "650-375-0452",
            "fax_number": "650-342-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEL",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 14459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Kim Kleiner
• Masha Kleusch-Mekhteys, D.D.S.
• David C. Klonoff, M.D.
• Angela Knox, RN
• Joseph Andrew Knox, MD
• Michael Anders Kohn, M.D.
• Lisa Kolvites
• Yohanna Konardi, DPT
• Edward Y Koo, M.D.
• Yelena Koss, M.D.

• Clinical Psychologist in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Clinical Psychologist in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.