Haley Morgan Roberson Issichopoulos, MSM, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

54940 Issued in CA

Practice address

844 Portola Rd
Portola Valley, CA 94028-7207

Phone

(650) 494-1000

NPI assigned

Nov 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1699288027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MOUNTAIN HOME RD",
            "city": "WOODSIDE",
            "state": "CA",
            "postal_code": "940622516",
            "telephone_number": "650-799-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 PORTOLA RD",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287207",
            "telephone_number": "650-494-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 University Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "East Palo Alto",
            "state": "CA",
            "postal_code": "943032213",
            "country_code": "US",
            "telephone_number": "650-494-1000",
            "fax_number": "650-494-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISSICHOPOULOS",
        "first_name": "HALEY",
        "middle_name": "MORGAN ROBERSON",
        "credential": "MSM, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "CA",
            "license": "54940",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "54950",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "54940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne F Henzel
• Rosemary Mayer Hintz, MFT
• Hoffman and Moore Chiropractic
• Ellen Marie Hoffman, D.C.
• Leslie Chia-Mei Hsu, M.D.
• Wilfred Edward Jaeger, M.D.
• Nile Kiyoto Jones, RN
• Courtney Blaire Jonson, L.AC.
• Daniel Aaron Kaplan, RN
• Jessica Kassis, M.D.

• Medical Physician Assistant in Portola Valley, CA
• Providers in Portola Valley, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.