Individual provider Active NPI

Cristina E Zadroga, PHD

  • Clinical Psychologist
  • Wilsonville, OR
National Provider Identifier
1740438365
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3366 Issued in OR
Practice address
29345 SW Town Center Loop E Ste 110
Wilsonville, OR 97070-8486
Phone
(503) 582-2100
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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 3366 OR Primary

Addresses

Primary practice location

29345 SW Town Center Loop E Ste 110
Wilsonville, OR 97070-8486

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

2400 Moorpark Ave
Suite 300
San Jose, CA 95128-2631
Phone (408) 975-2745

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address czadroga1805367@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130814000368 CA Practitioner - Clinical Psychologist 2668614017 Reassigns benefits to 1 organization
I20210826001375 OR Practitioner - Clinical Psychologist 2668614017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

29345 SW Town Ctr Loop E
Suite 110
Wilsonville, OR 97070-8486
Phone (503) 582-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3366ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Jun 19, 2013 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2021 Accepting new patients
Permanente Medical Group Inc CurrentSince Jun 19, 2013 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2021 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

29345 SW Town Center Loop E
Ste 110
Wilsonville, OR 97070
Phone (503) 582-2100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1740438365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29345 SW TOWN CENTER LOOP E STE 110",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970708486",
            "telephone_number": "503-582-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Moorpark Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282631",
            "country_code": "US",
            "telephone_number": "408-975-2745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZADROGA",
        "first_name": "CRISTINA",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "czadroga1805367@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "29345 SW Town Center Loop E Ste 110",
            "city": "Wilsonville",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970708486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

Verify at the official NPI Registry.