NPIMap

Organization Active NPI

Pacific Neurohealth, a Psychological Corporation

  • Psychologist
  • Pacifica, CA
National Provider Identifier
1811386402
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 22834 Issued in CA
Legal business name
PACIFIC NEUROHEALTH, A PSYCHOLOGICAL CORPORATION
Practice address
80 Eureka SQ
Suite 218
Pacifica, CA 94044-2654
Phone
(650) 245-5503
NPI assigned
Jan 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Authorized official

Name
Dr. Michael Cole, PHD
Title
President
Phone
(650) 245-5503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY 22834 CA Primary

Addresses

Primary practice location

80 Eureka SQ
Suite 218
Pacifica, CA 94044-2654

Mailing address

80 Eureka SQ
Suite 218
Pacifica, CA 94044-2654
Phone (650) 245-5503

National Provider Directory

National Provider Directory

Locations

80 Eureka Sq
Ste 218
Pacifica, CA 94044
Phone (650) 245-5503

NPI Registry JSON

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1811386402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 EUREKA SQ",
            "address_2": "SUITE 218",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442654",
            "telephone_number": "650-245-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 EUREKA SQ",
            "address_2": "SUITE 218",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442654",
            "telephone_number": "650-245-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NEUROHEALTH, A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-245-5503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 22834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacifica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.