Active NPI
Sue Stephenson, PHD
- Clinical Psychologist
- Fort Irwin, CA
National Provider Identifier
1598464760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY2414
- Practice address
- 390 North Loop Rd.
Weed Army Community Hospital
Fort Irwin, CA 92310 - Phone
- (760) 383-5280
- NPI assigned
- Feb 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PY2414 | WA | |
| Clinical Psychologist | 103TC0700X | PY2414 | WA | Primary |
Addresses
Primary practice location
390 North Loop Rd.
Weed Army Community Hospital
Fort Irwin, CA 92310
Mailing address
PO Box 1402
Solana Beach, CA 92075-7402
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY2414 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1598464760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1402",
"city": "SOLANA BEACH",
"state": "CA",
"postal_code": "920757402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 NORTH LOOP RD.",
"address_2": "WEED ARMY COMMUNITY HOSPITAL",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "760-383-5280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "SUE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-27",
"last_updated": "2023-02-27",
"certification_date": "2023-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WA",
"license": "PY2414",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY2414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.