Individual provider Active NPI

Pamela Wu Poff, PH.D.

  • Psychologist
  • El Dorado Hills, CA
National Provider Identifier
1851487631
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY19224 Issued in CA
Practice address
1212 Suncast LN Ste 1
El Dorado Hills, CA 95762-9685
Phone
(916) 790-4243
NPI assigned
Oct 5, 2006
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY19224 CA Primary

Addresses

Primary practice location

1212 Suncast LN Ste 1
El Dorado Hills, CA 95762-9685

Mailing address

PO Box 5111
El Dorado Hills, CA 95762-0003
Phone (916) 790-4243

Other practice location 1

12300 Highway A1A Alt
Suite 209C
Palm Beach Gardens, FL 33410-2205
Phone (561) 891-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20031106000829 CA Practitioner - Clinical Psychologist 7911810825 Practice locations: El Dorado Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Hawaii John a. Burns School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5170 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9608
Phone (916) 790-4243

PO Box
Suite 5111
El Dorado Hills, CA 95762

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY19224CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Health Group PC PastSince Jul 1, 2014 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1851487631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5111",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957620003",
            "telephone_number": "916-790-4243",
            "fax_number": "916-357-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 SUNCAST LN STE 1",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629685",
            "telephone_number": "916-790-4243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12300 Highway A1A Alt",
            "address_2": "Suite 209C",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334102205",
            "country_code": "US",
            "telephone_number": "561-891-1511",
            "fax_number": "561-746-8297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POFF",
        "first_name": "PAMELA",
        "middle_name": "WU",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

Verify at the official NPI Registry.