Active NPI
Stephanie T. Imp
- School Psychologist
- Santa Ana, CA
National Provider Identifier
1831600162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 94023427
- Practice address
- 2107 N Broadway
Suite 207
Santa Ana, CA 92706 - Phone
- (714) 972-0040
- NPI assigned
- Oct 13, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 94023427 | Primary |
Addresses
Primary practice location
2107 N Broadway
Suite 207
Santa Ana, CA 92706
Mailing address
P.O. Box 6299
Laguna Niguel, CA 92607
Phone (714) 972-0040
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Assessment Services | Past | Accepting new patients | |
| Psychological Assessment Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Group Psychotherapy Psychologist
- Santa Ana, CA
- NPI 1801059597
-
- Clinical Psychologist
- Santa Ana, CA
- NPI 1982895421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507852800000",
"number": "1831600162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 6299",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "92607",
"telephone_number": "714-972-0040",
"fax_number": "714-460-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2107 N BROADWAY",
"address_2": "SUITE 207",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "92706",
"telephone_number": "714-972-0040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMP",
"first_name": "STEPHANIE",
"middle_name": "T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-13",
"last_updated": "2017-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": "94023427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.