Active NPI
Victoria Pietruszka, JD, PHD
- Clinical Psychologist
- Elk Grove, CA
National Provider Identifier
1740021591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35083
- Practice address
- 12500 Bruceville Rd
Elk Grove, CA 95757-9784 - Phone
- (916) 876-5343
- NPI assigned
- Jun 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 11904 | MA | |
| Clinical Psychologist | 103TC0700X | 35083 | CA | Primary |
Addresses
Primary practice location
12500 Bruceville Rd
Elk Grove, CA 95757-9784
Mailing address
9049 Stinson Beach Way
Elk Grove, CA 95758-5155
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
- Juris Doctor, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11904 | MA | MD | Mental Health Counselor |
| 35083 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1740021591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9049 STINSON BEACH WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957585155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12500 BRUCEVILLE RD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957579784",
"telephone_number": "916-876-5343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIETRUSZKA",
"first_name": "VICTORIA",
"credential": "JD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-05",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "11904",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "35083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.