Individual provider Active NPI

Katharine Pratt Dahl, M.S.

  • Clinical Child & Adolescent Psychologist
  • Stanford, CA
National Provider Identifier
1578823977
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY26641 Issued in CA
Practice address
401 Quarry Rd.
Stanford, CA 94305-5719
Phone
(650) 723-5511
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY26641 CA Primary

Addresses

Primary practice location

401 Quarry Rd.
Stanford, CA 94305-5719

Mailing address

401 Quarry Rd.
Stanford, CA 94305-5719
Phone (650) 723-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141107000003 CA Practitioner - Clinical Psychologist 0941422984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LPCH Medical Group Div of LucileGroup PAC ID 0840298543, 332 clinicians

Practice addresses (Care Compare)

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 498-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY26641CAMDClinical Child & Adolescent Psychologist
26641CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care Current Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Aug 30, 2014 Accepting new patients
Stanford Health Care CurrentSince Feb 24, 2015 Accepting new patients
Stanford Health Care CurrentSince Feb 24, 2015 Accepting new patients

Locations

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

401 Quarry Rd
Palo Alto, CA 94304
Phone (650) 498-9111

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

1195 W Fremont Ave
Sunnyvale, CA 94087
Phone (408) 426-5590

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1578823977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD.",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055719",
            "telephone_number": "650-723-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD.",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055719",
            "telephone_number": "650-723-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "KATHARINE",
        "middle_name": "PRATT",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY26641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.