Maria Jose Prieto de Estebecorena, PH,D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY22819 Issued in CA

Practice address

2154 4TH St
San Rafael, CA 94901-2694

Phone

(415) 457-3451

Fax

(415) 457-3819

NPI assigned

Aug 3, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Maria Jose Estebecorena Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1013148469",
    "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": "949012694",
            "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": "949012694",
            "telephone_number": "415-457-3451",
            "fax_number": "415-457-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO DE ESTEBECORENA",
        "first_name": "MARIA JOSE",
        "credential": "PH,D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY22819",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA JOSE",
            "last_name": "ESTEBECORENA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth Susanna Pretorius
• Pamela Pretty, PTA, MS
• Preventive Medical Center of Marin Inc
• Paul Pribuss, PAUL PRIBUSS
• Marian Elizabeth Price, MFT
• Prima Medical Group-Terra Linda
• Prima Medical Group, Inc.
• Prima Medical Group, Inc.
• Brianna Prince, RDH
• Stephen Lochrane Prince, ICADC

• 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 Mar 14, 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.