Individual provider Active NPI

Emily Waller Paolillo

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1639932882
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34670 Issued in CA
Practice address
1651 4TH St Ste 212
San Francisco, CA 94158-2324
Phone
(347) 661-5999
NPI assigned
Jan 31, 2024
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 PSY34670 CA Primary

Addresses

Primary practice location

1651 4TH St Ste 212
San Francisco, CA 94158-2324

Mailing address

675 Nelson Rising LN Ste 190
San Francisco, CA 94158-2506

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240318002110 CA Practitioner - Clinical Psychologist 1153768890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2330 Post St
San Francisco, CA 94115-3465
Phone (415) 476-4029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY34670CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Jan 31, 2024 Accepting new patients
University of California San Francisco CurrentSince Jan 31, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jan 31, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jan 31, 2024 Accepting new patients

Locations

675 Nelson Rising Ln
Ste 190
San Francisco, CA 94143
Phone (415) 353-2057

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

1651 4th St
Ste 212
San Francisco, CA 94158
Phone (415) 353-2057

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1639932882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 NELSON RISING LN STE 190",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 4TH ST STE 212",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582324",
            "telephone_number": "347-661-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLILLO",
        "first_name": "EMILY",
        "middle_name": "WALLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.