Active NPI
Malay Phoong, PHD
- Clinical Psychologist
- Sacramento, CA
National Provider Identifier
1629557558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 30236
- Practice address
- 1625 Stockton Blvd Ste 104
Sacramento, CA 95816-7098 - Phone
- (916) 262-9110
- Fax
- (916) 262-9074
- NPI assigned
- Aug 10, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 30236 | CA | Primary |
Addresses
Primary practice location
1625 Stockton Blvd Ste 104
Sacramento, CA 95816-7098
Mailing address
10470 Old Placerville Rd Ste 100
Sacramento, CA 95827-2539
Phone (800) 470-0071
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 |
|---|---|---|---|
| 30236 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Sutter Regional Medical Foundation | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Fairfield, CA
- NPI 1558388504
-
- General Acute Care Hospital
- Sacramento, CA
- NPI 1811946734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538438400000",
"number": "1629557558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 OLD PLACERVILLE RD STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958272539",
"telephone_number": "800-470-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 STOCKTON BLVD STE 104",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958167098",
"telephone_number": "916-262-9110",
"fax_number": "916-262-9074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHOONG",
"first_name": "MALAY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-10",
"last_updated": "2018-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "30236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.