Active NPI
Ellen Haller, MD
- Psychiatry Physician
- San Francisco, CA
National Provider Identifier
1891747119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G57451
- Practice address
- 401 Parnassus Ave
San Francisco, CA 94143-2211 - Phone
- (415) 476-7799
- Fax
- (415) 502-2661
- NPI assigned
- May 16, 2006
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G57451 | CA | Primary |
Addresses
Primary practice location
401 Parnassus Ave
San Francisco, CA 94143-2211
Mailing address
1635 Divisadero Street, Suite 625, Box 1821
San Francisco, CA 94143-0001
Phone (415) 476-4029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G574510 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G57451 | CA | MD | Psychiatry Physician |
| 57451 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1891747119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 DIVISADERO STREET, SUITE 625, BOX 1821",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941430001",
"telephone_number": "415-476-4029",
"fax_number": "415-476-4150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 PARNASSUS AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941432211",
"telephone_number": "415-476-7799",
"fax_number": "415-502-2661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLER",
"first_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G57451",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G574510",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.