Active NPI
Benjamin Page, PSY.D.
- Clinical Psychologist
- Palo Alto, CA
National Provider Identifier
1629407267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY25964
- Practice address
- 117 S California Ave
Suite D201
Palo Alto, CA 94306-5103 - Phone
- (650) 596-2601
- NPI assigned
- Nov 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY25964 | CA | Primary |
Addresses
Primary practice location
117 S California Ave
Suite D201
Palo Alto, CA 94306-5103
Mailing address
PO Box 901
Mountain View, CA 94042-0901
Phone (650) 596-2601
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25964 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1629407267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 901",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940420901",
"telephone_number": "650-596-2601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 S CALIFORNIA AVE",
"address_2": "SUITE D201",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943065103",
"telephone_number": "650-596-2601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "BENJAMIN",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-04",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY25964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.