Carl St Goar

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

94028537 Issued in CA

Practice address

617 Veterans Blvd Ste 107
Redwood City, CA 94063-1404

Phone

(650) 503-8179

NPI assigned

Sep 11, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• The Wise Mind Institute, a Psychological Corporation

  • Psychologist
  • Redwood City, CA
  • NPI 1174990360
  NPD

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1962238303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 VETERANS BLVD STE 107",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631404",
            "telephone_number": "650-503-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 VETERANS BLVD STE 107",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631404",
            "telephone_number": "650-503-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST GOAR",
        "first_name": "CARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "94028537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spring Day Wellness LLC
• Anna Springer, RN
• Zandalee Springs
• Deepa Srinivasan, M.D.
• Kalpana Srinivasan, MD
• Emily Bolton St. John
• St. Therese Convalescent Hospital ,Inc.
• Sara Christine Rochotte Stabile, MD
• Ginny Stacey, PHARM.D.
• Cindy Stack-Keer, RD

• Clinical Psychologist in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.