Individual provider Active NPI

Suangsmorn Stapatyanon, PH.D.

  • Clinical Psychologist
  • Orange, CA
National Provider Identifier
1720395163
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 16951 Issued in CA
Practice address
301 N Rampart St
Suite E
Orange, CA 92868-1854
Phone
(714) 704-4545
NPI assigned
Sep 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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 PSY 16951 CA Primary

Addresses

Primary practice location

301 N Rampart St
Suite E
Orange, CA 92868-1854

Mailing address

301 N Rampart St
Suite E
Orange, CA 92868-1854
Phone (714) 704-4545

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 16951CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1720395163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N RAMPART ST",
            "address_2": "SUITE E",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681854",
            "telephone_number": "714-704-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N RAMPART ST",
            "address_2": "SUITE E",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681854",
            "telephone_number": "714-704-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPATYANON",
        "first_name": "SUANGSMORN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 16951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.