Leland Vandendale, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 9210 Issued in CA

Practice address

870 Market St Ste 1186
San Francisco, CA 94102-2922

Phone

(415) 359-4117

NPI assigned

Apr 11, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Leland Van Den Daele Professional name

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

Specialty

Clinical Psychologist

Education

Other, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1609309103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 FAIRWAY DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949281440",
            "telephone_number": "415-359-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MARKET ST STE 1186",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941022922",
            "telephone_number": "415-359-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENDALE",
        "first_name": "LELAND",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "CA",
            "license": "PSY 9210",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY 9210",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY 9210",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 9210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LELAND",
            "last_name": "VAN DEN DAELE",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rachael Marie Vandebogart, MD
• Guy J Vandenberg, MSW, RN
• Hayley Rae Vandenberg, PA
• Scott R. Vandenberg, MD
• Victoria Vandenberg, PHARMD
• Nancy Lee Vander Linden, RN
• Kurt Edward Vander Schalie, PT ATC
• Lois Vanderhagen, M.D.
• Brianna Joy Vandersloot, DPT, PT
• Haley Nicole Vandeweg

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.