Active NPI
Mirella Flores Randelman, PHD
- Counseling Psychologist
- Burlingame, CA
National Provider Identifier
1932548526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY.0005591
- Practice address
- 287 Lorton Ave
Burlingame, CA 94010-4203 - Phone
- (877) 505-7147
- NPI assigned
- Jun 18, 2013
- Last updated
- Jun 15, 2023
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY.0005591 | CO | Primary |
Addresses
Primary practice location
287 Lorton Ave
Burlingame, CA 94010-4203
Mailing address
3876 Golf Village Loop Apt 5
Lakeland, FL 33809-4087
Phone (561) 603-2027
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0005591 | CO | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1932548526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3876 GOLF VILLAGE LOOP APT 5",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338094087",
"telephone_number": "561-603-2027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "287 LORTON AVE",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940104203",
"telephone_number": "877-505-7147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDELMAN",
"first_name": "MIRELLA",
"middle_name": "FLORES",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-18",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CO",
"license": "PSY.0005591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlingame, CA
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- Emily Yvonne Raffa, FNP
- Sarah Raffaelli
- Karla J Ramirez, LCSW
- Kenedy E Ramos, PSY.D.
- Jamie Rankin, PMHNP
- Rashmi Jain M D Professional Corporation
- Shamika Monea Rauls
- Shetal Desai Rautela, RD, CDE
- Ray of Hope Child Therapy Services Inc (T Johnson's Counseling Service)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.