Individual provider Active NPI

Stephan P. Wyss, MD

  • Psychiatry Physician
  • South San Francisco, CA
National Provider Identifier
1932287539
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A52389 Issued in CA
Practice address
1200 El Camino Real
South San Francisco, CA 94080-3208
Phone
(650) 742-2000
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A52389 CA Primary

Addresses

Primary practice location

1200 El Camino Real
South San Francisco, CA 94080-3208

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3429
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A523890MedicaidCA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110331000608 CA Practitioner - Psychiatry 8628251469 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52389CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jul 25, 2018 Accepting new patients
County of San Mateo CurrentSince Aug 1, 2017 Accepting new patients
University of California San Francisco CurrentSince Sep 1, 2018 Accepting new patients
City & County of San Francisco Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jul 25, 2018 Accepting new patients
County of San Mateo CurrentSince Aug 1, 2017 Accepting new patients
University of California San Francisco Psychiatry Current Accepting new patients
University of California, San Francisco Psychiatry CurrentSince Sep 1, 2018 Accepting new patients
City and County of San Francisco CurrentSince Jun 30, 2020 Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 10

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932287539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EL CAMINO REAL",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803208",
            "telephone_number": "650-742-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSS",
        "first_name": "STEPHAN",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A52389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A523890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

Verify at the official NPI Registry.