Active NPI
Annemieke De Jong, PH.D.
- Psychologist
- San Francisco, CA
National Provider Identifier
1992814834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY15584
- Practice address
- 2171 Union St
Suite 4
San Francisco, CA 94123-4003 - Phone
- (415) 346-8144
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY15584 | CA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY15584 | CA | |
| Psychologist | 103T00000X | PSY15584 | CA | Primary |
Addresses
Primary practice location
2171 Union St
Suite 4
San Francisco, CA 94123-4003
Mailing address
2171 Union St
Suite 4
San Francisco, CA 94123-4003
Phone (415) 346-8144
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0PL155840 | Other | CA | BLUE SHIELD |
| 188081 | Other | CA | MANAGED HEATLTH NETWORK |
Other names 1
- Dr. Annie De Jong
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15584 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1992814834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2171 UNION ST",
"address_2": "SUITE 4",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941234003",
"telephone_number": "415-346-8144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2171 UNION ST",
"address_2": "SUITE 4",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941234003",
"telephone_number": "415-346-8144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JONG",
"first_name": "ANNEMIEKE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY15584",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY15584",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY15584",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "0PL155840",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEATLTH NETWORK",
"identifier": "188081",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNIE",
"last_name": "DE JONG",
"prefix": "DR.",
"credential": "PH.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.