Individual provider Active NPI

Amber Vail Williamson

  • Psychologist
  • Denver, CO
National Provider Identifier
1962634584
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY0004512 Issued in CO
Practice address
5388 Valentia St
Denver, CO 80238-3842
Phone
(207) 522-5243
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X PSY0004512 CO Primary

Addresses

Primary practice location

5388 Valentia St
Denver, CO 80238-3842

Mailing address

5388 Valentia St
Denver, CO 80238-3842
Phone (207) 522-5243

Other practice location 1

3081 Teagarden St
San Leandro, CA 94577-5720
Phone (510) 347-4620

Other identifiers 3

IdentifierTypeStateIssuer
8416054-2501OtherUTPSYCHOLOGIST
9823OtherMACLINICAL PSYCHOLOGY
PSY0004512OtherCOCLINICAL PSYCHOLOGY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY0004512COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sakura Assessment and Therapy, LLC Psychologist Current Accepting new patients

Organizations & group practices 1

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1962634584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5388 VALENTIA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383842",
            "telephone_number": "207-522-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5388 VALENTIA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383842",
            "telephone_number": "207-522-5243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3081 Teagarden St",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945775720",
            "country_code": "US",
            "telephone_number": "510-347-4620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "AMBER",
        "middle_name": "VAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY0004512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "8416054-2501",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGY",
            "identifier": "9823",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGY",
            "identifier": "PSY0004512",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.