Individual provider Active NPI

Emily Jade Hennrich, PHD

  • Psychologist
  • San Diego, CA
National Provider Identifier
1962963421
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
29140 Issued in CA
Practice address
12625 High Bluff Dr Ste 111
San Diego, CA 92130-2053
Phone
(858) 692-4187
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 29140 CA Primary

Addresses

Primary practice location

12625 High Bluff Dr Ste 111
San Diego, CA 92130-2053

Mailing address

PO Box 230218
Encinitas, CA 92023-0218

Other practice location 1

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (800) 516-0975

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
29140CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychologist Current Accepting new patients
Roots Psychiatric Services PC Past Accepting new patients
The Halliday Center for Psychotherapy and Wellness, Inc. PastSince Jun 25, 2014 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: emilyhennrich@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1962963421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230218",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920230218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR STE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302053",
            "telephone_number": "858-692-4187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Welch Rd",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041601",
            "country_code": "US",
            "telephone_number": "800-516-0975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNRICH",
        "first_name": "EMILY",
        "middle_name": "JADE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "29140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.