Individual provider Active NPI

Julia Nunan-Saah, PHD

  • Clinical Neuropsychologist
  • San Mateo, CA
National Provider Identifier
1679922322
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY30488 Issued in CA
Practice address
2000 Alameda de Las Pulgas
Suite 242
San Mateo, CA 94403
Phone
(650) 931-6514
Fax
(833) 989-0246
NPI assigned
Jun 3, 2016
Reactivated
Jan 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY30488 CA Primary

Addresses

Primary practice location

2000 Alameda de Las Pulgas
Suite 242
San Mateo, CA 94403

Mailing address

2000 Alameda de Las Pulgas
Suite 242
San Mateo, CA 94403
Phone (650) 931-6514

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

Practice roles

OrganizationSpecialtyStatusNew patients
Child Mind Medical Practice, PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

2000 Alameda de las Pulgas
Ste 242
San Mateo, CA 94403
Phone (650) 229-7696

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1679922322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 ALAMEDA DE LAS PULGAS",
            "address_2": "SUITE 242",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-931-6514",
            "fax_number": "833-989-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ALAMEDA DE LAS PULGAS",
            "address_2": "SUITE 242",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-931-6514",
            "fax_number": "833-989-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNAN-SAAH",
        "first_name": "JULIA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "deactivation_date": "2017-07-25",
        "reactivation_date": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY30488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.