Individual provider Active NPI

Jacquelyn Szajer, PH.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1952099004
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY33943 Issued in CA
Practice address
10021 Willow Creek Rd Ste 200
San Diego, CA 92131-1670
Phone
(310) 571-8130
NPI assigned
Apr 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY33943 CA Primary

Addresses

Primary practice location

10021 Willow Creek Rd Ste 200
San Diego, CA 92131-1670

Mailing address

10021 Willow Creek Rd Ste 200
San Diego, CA 92131-1670

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240102002803 CA Practitioner - Clinical Psychologist 4688024763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minder Neuropsychological Services IncGroup PAC ID 8729442819, 9 clinicians

Practice addresses (Care Compare)

4015 Louisiana St
Unit 4
San Diego, CA 92104-2434
Phone (858) 228-7422

6190 Cornerstone CT E
Suite 216
San Diego, CA 92121-4701
Phone (858) 914-1347

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY33943CAMDPsychologist
33943CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Minder Neuropsychological Services Inc. Psychologist CurrentSince Nov 15, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1952099004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 WILLOW CREEK RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 WILLOW CREEK RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311670",
            "telephone_number": "310-571-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZAJER",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.