Active NPI
Ellen Colangelo, PH.D.
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1902826563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY14129
- Practice address
- 3180 University Avenue
Suite 210
San Diego, CA 92104-2045 - Phone
- (619) 807-5431
- Fax
- (619) 291-3441
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY14129 | CA | Primary |
Addresses
Primary practice location
3180 University Avenue
Suite 210
San Diego, CA 92104-2045
Mailing address
3957 30TH Street
#517
San Diego, CA 92104-3085
Phone (619) 807-5431
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8042827 | 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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY14129 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Care Chiropractic Dr. Majid Taghizadeh D.C, Inc. | Past | 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 and National Provider Directory roles.
-
- Chiropractor
- San Diego, CA
- NPI 1659529428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287360000000",
"number": "1902826563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3957 30TH STREET",
"address_2": "#517",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921043085",
"telephone_number": "619-807-5431",
"fax_number": "619-291-3441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3180 UNIVERSITY AVENUE",
"address_2": "SUITE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921042045",
"telephone_number": "619-807-5431",
"fax_number": "619-291-3441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLANGELO",
"first_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2010-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY14129",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8042827",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.