Individual provider Active NPI

Elissa Meryl, PSY.D.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1619027778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY17480 Issued in CA
Practice address
1965 Hayes St
San Francisco, CA 94117-1125
Phone
(415) 386-0537
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY17480 CA Primary

Addresses

Primary practice location

1965 Hayes St
San Francisco, CA 94117-1125

Mailing address

1965 Hayes St
San Francisco, CA 94117-1125
Phone (415) 386-0537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY17480CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619027778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 HAYES ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171125",
            "telephone_number": "415-386-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 HAYES ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171125",
            "telephone_number": "415-386-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERYL",
        "first_name": "ELISSA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.