Individual provider Active NPI

Adeleine Conanan Liang, PSYD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1720393242
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31748 Issued in CA
Practice address
5230 Carroll Canyon Rd Ste 316
San Diego, CA 92121-1781
Phone
(619) 436-4231
NPI assigned
Aug 9, 2010
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 31748 CA Primary

Addresses

Primary practice location

5230 Carroll Canyon Rd Ste 316
San Diego, CA 92121-1781

Mailing address

PO Box 161247
San Diego, CA 92176-1247
Phone (619) 436-4231

Other names 1

  • Dr. Adeleine Conanan Professional name

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

State licenses

LicenseStateTypeSpecialty
31748CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aco Psychology Inc Clinical CurrentSince Jul 17, 2022 Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Clinical Past Accepting new patients

Locations

5230 Carroll Canyon Rd
Ste 316
San Diego, CA 92121
Phone (619) 436-4231

Organizations & group practices 3

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": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1720393242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161247",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921761247",
            "telephone_number": "619-436-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 CARROLL CANYON RD STE 316",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211781",
            "telephone_number": "619-436-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIANG",
        "first_name": "ADELEINE",
        "middle_name": "CONANAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADELEINE",
            "last_name": "CONANAN",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.