Marin Neuropsychology and Psychological Center, PC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY13957 Issued in CA

Legal business name

MARIN NEUROPSYCHOLOGY AND PSYCHOLOGICAL CENTER, PC

Practice address

2154 4TH St
San Rafael, CA 94901-2684

Phone

(415) 457-3451

Fax

(415) 457-3819

NPI assigned

Jun 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Edgar Angelone, PHD

Title

President

Phone

(415) 457-3451

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1003102393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 4TH ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012684",
            "telephone_number": "415-457-3451",
            "fax_number": "415-457-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 4TH ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012684",
            "telephone_number": "415-457-3451",
            "fax_number": "415-457-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN NEUROPSYCHOLOGY AND PSYCHOLOGICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "ANGELONE",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-457-3451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY13957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marin Hills Medical Group Inc
• Marin Home Care Inc
• Marin Housing Authority
• Marin Individual Practice Association
• Marin Naturopathic Medicine
• Marin Neuropsychology Center - a Psychology Corporation
• Marin Ophthalmic Consultants, a Medical Corporation
• Marin Ophthalmic Gallary
• Marin Ophthalmic Surgery Center
• Marin Optometric Group, Inc

• Clinical Neuropsychologist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.