Marissa A Robinson, PSYD
Individual provider Active NPI Clinical Psychologist · Fairfax, CA
NPI 1003932997 · NPPES record last updated Jul 20, 2016
Key facts
- NPI
- 1003932997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY25119 (CA)
- Practice address
- 155 Frustuck Ave
Fairfax, CA 94930-1906 - Phone
- (415) 754-0451
- Fax
- (855) 344-5560
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
333 Hayes St
Suite 104
San Francisco, CA 94102-4455
Phone (415) 420-5567
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131029000969 | CA | Practitioner - Clinical Psychologist | 4587899588 | Practice locations: San Francisco, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25119 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY25119 | CA | Yes |
Addresses
Primary practice location
155 Frustuck Ave
Fairfax, CA 94930-1906
Mailing address
155 Frustuck Ave
Fairfax, CA 94930-1906
Phone (415) 420-5567
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9967 | Other | SFGH INTERNAL USE ONLY | |
| 9967 | Other | CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER |
Other providers in Fairfax, CA
- Gislene Maria Peral
- Maria Quintana-Pilling
- Denise M Renye
- Lea Ritter
- Anjanetta Lynn Ro-Trock
- Pamela Roman
- Steven Rudnitzky
- Sonya Sakaske
- Caroline Scippa
- Cathryn Selby
All providers in Fairfax, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.