Active NPI
Penelope Clizbe
- Psychologist
- San Mateo, CA
National Provider Identifier
1912635137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 1900 S Norfolk St Ste 205
San Mateo, CA 94403-1184 - Phone
- (650) 242-0179
- NPI assigned
- Aug 15, 2022
- Last updated
- Aug 15, 2022
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | Primary |
Addresses
Primary practice location
1900 S Norfolk St Ste 205
San Mateo, CA 94403-1184
Mailing address
1653 Merrill Dr Apt a
San Jose, CA 95124-5915
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pclizbe@palsautism.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660521600000",
"number": "1912635137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1653 MERRILL DR APT A",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951245915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 S NORFOLK ST STE 205",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944031184",
"telephone_number": "650-242-0179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIZBE",
"first_name": "PENELOPE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-15",
"last_updated": "2022-08-15",
"certification_date": "2022-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pclizbe@palsautism.com",
"affiliation": "N",
"address_1": "1900 S Norfolk St Ste 205",
"city": "San Mateo",
"state": "CA",
"country_code": "US",
"postal_code": "944031184",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.