Active NPI
Michaela Ene, PH.D.
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1609013119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 17703
- Practice address
- 550 Washington St Suite 300
San Diego, CA 92103 - Phone
- (619) 297-5437
- Fax
- (619) 297-4567
- NPI assigned
- Jan 21, 2009
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 17703 | CA | |
| Clinical Psychologist | 103TC0700X | 17703 | CA | Primary |
Addresses
Primary practice location
550 Washington St Suite 300
San Diego, CA 92103
Mailing address
550 Washington St Suite 300
San Diego, CA 32103
Phone (619) 297-5437
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17703 | CA | MD | Clinical Psychologist |
| 17703 | CA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525219200000",
"number": "1609013119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 WASHINGTON ST SUITE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "32103",
"telephone_number": "619-297-5437",
"fax_number": "619-297-4567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 WASHINGTON ST SUITE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92103",
"telephone_number": "619-297-5437",
"fax_number": "619-297-4567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENE",
"first_name": "MICHAELA",
"name_prefix": "Mrs.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-21",
"last_updated": "2018-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 17703",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "17703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.