Stephanie Yamada Mitsuuchi, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35339 Issued in CA

Practice address

2525 Cherry Ave Ste 350
Signal Hill, CA 90755-2061

Phone

(562) 740-8477

NPI assigned

Feb 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Soultenders Psychological Services, Inc.

  • Clinical Social Worker
  • Arcadia, CA
  • NPI 1235810722
  NPD
• Soultenders, Inc.

  • Clinical Psychologist
  • Arcadia, CA
  • NPI 1164617007
  NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1932240876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21143 HAWTHORNE BLVD # 336",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHERRY AVE STE 350",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907552061",
            "telephone_number": "562-740-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA MITSUUCHI",
        "first_name": "STEPHANIE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "PSB94027414",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "PSB94027414",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willow Urgent Care, a Subsidiary of Memorial Healthcare Ipa
• Nevielle Kay Arana Winter, MA, AMFT
• Larry F Wong, CP
• Stanley Shawn Wong, AMFT
• David Wu, DPT
• Kai Gabriel Genung Yamamoto, OTR/L
• Kay Yan, M.D.
• Sharam Samson Yashar, MD
• Andrew Yorke, PT, MPT
• Marien Guadalupe Zavala, AGAC-NP

• Clinical Psychologist in Signal Hill, CA
• Providers in Signal Hill, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.