Active NPI
Daniel Ryu
- Psychologist
- Palo Alto, CA
National Provider Identifier
1649777491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 3801 Miranda Ave
Palo Alto, CA 94304-1207 - Phone
- (650) 493-5000
- NPI assigned
- Apr 9, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
3801 Miranda Ave
Palo Alto, CA 94304-1207
Mailing address
2443 Fillmore St # 380-5173
San Francisco, CA 94115-1814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 11, 2025 through Jun 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1649777491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2443 FILLMORE ST # 380-5173",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941151814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 MIRANDA AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041207",
"telephone_number": "650-493-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYU",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-09",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"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 Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.