Myra Gueco Bernecker, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY21427 Issued in CA

Practice address

1036 Sir Francis Drake Blvd Ste 204
Kentfield, CA 94904-1440

Phone

(415) 354-4241

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Maria Eudora Gueco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Robert S. Hausner M.D., Professional Corporation

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1972666196
  NPD (past)
• Stephen Allison, M.D., a Professional Corporation

  • Psychiatry Physician
  • Sausalito, CA
  • NPI 1326436668
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1003033267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 SIR FRANCIS DRAKE BLVD STE 204",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041440",
            "telephone_number": "415-354-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 SIR FRANCIS DRAKE BLVD STE 204",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041440",
            "telephone_number": "415-354-4241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2354 Post St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941153424",
            "country_code": "US",
            "telephone_number": "415-354-4241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNECKER",
        "first_name": "MYRA",
        "middle_name": "GUECO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "GUECO",
            "middle_name": "EUDORA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gordon David Baumbacher, M.D.
• Philip Beitel, M.A., M.S., MFT
• Debra Michelle Bellings-Kee, MFT
• Justine Meunier Fiebelkorn Benavente, OTR/L
• Jenny Benoit
• Alexander Geoffrey Bloom, LCSW
• Jillian A Boeri, LMFT
• Linda Boghrati, MFT
• David John Borgeson, MPT, MS
• Linda Christine Boyd-Cornell, L.M.F.T.

• All providers in Kentfield, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.