Individual provider Active NPI

Elena Cherkasova, PSY.D.

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1720249709
Registry record updated Feb 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24730 Issued in CA
Practice address
795 Willow Rd
Mailcode: 152
Menlo Park, CA 94025-2539
Phone
(650) 493-5000
NPI assigned
Jun 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2012

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 24730 CA Primary

Addresses

Primary practice location

795 Willow Rd
Mailcode: 152
Menlo Park, CA 94025-2539

Mailing address

795 Willow Rd
Mailcode: 152
Menlo Park, CA 94025-2539
Phone (650) 493-5000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24730CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1214092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330214400000",
    "number": "1720249709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD",
            "address_2": "MAILCODE: 152",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-493-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD",
            "address_2": "MAILCODE: 152",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-493-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERKASOVA",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-22",
        "last_updated": "2012-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2012; 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.