Stacia Deiro, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

34836 Issued in CA

Practice address

4105 E Broadway Ste 202
Long Beach, CA 90803-1503

Phone

(562) 285-6776

NPI assigned

Jun 4, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Provia Psychology, Inc.

  • Psychologist
  • Long Beach, CA
  • NPI 1932718350
  NPD Authorized official

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1760862643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 E BROADWAY STE 202",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908031503",
            "telephone_number": "562-285-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 E BROADWAY STE 202",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908031503",
            "telephone_number": "562-285-6776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 Dove St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926602853",
            "country_code": "US",
            "telephone_number": "562-285-6776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEIRO",
        "first_name": "STACIA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT113415",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "34836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Dehaan, MSW
• Milton Deherrera, RN
• Emma Wynn Dehorn
• Drakirah L Deichert
• John Mgrditch Deirmenjian, M.D.
• Clayton B Dejong, MD
• David Del Francia
• Marie Antoni Cortes Del Mar
• Cassondra Del Rosario, M.A., M.A., LPCC
• Charlize Kelli Del Rosario, RDN

• Psychologist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.