Individual provider Active NPI

James Anthony Mazzone II, PH.D.

  • Clinical Psychologist
  • Burlingame, CA
National Provider Identifier
1942465281
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 22067 Issued in CA
Practice address
1820 Ogden Dr Ste 11
Burlingame, CA 94010-5384
Phone
(650) 787-5194
NPI assigned
Jul 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 22067 CA Primary

Addresses

Primary practice location

1820 Ogden Dr Ste 11
Burlingame, CA 94010-5384

Mailing address

1820 Ogden Dr Ste 11
Burlingame, CA 94010-5384
Phone (650) 787-5194

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

LicenseStateTypeSpecialty
PSY 22067CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1942465281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 OGDEN DR STE 11",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105384",
            "telephone_number": "650-787-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 OGDEN DR STE 11",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105384",
            "telephone_number": "650-787-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZONE",
        "first_name": "JAMES",
        "middle_name": "ANTHONY",
        "name_suffix": "II",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.