Mara Lenox Bronstein, PSY.D.
Individual provider Active NPI Clinical Psychologist · Los Altos, CA
NPI 1013205277 · NPPES record last updated Jul 20, 2011
Key facts
- NPI
- 1013205277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY 24355 (CA)
- Practice address
- 881 Fremont Ave
Suite B8
Los Altos, CA 94024-5697 - Phone
- (650) 231-4835
- NPI assigned
- Jul 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
881 Fremont Ave
B8
Los Altos, CA 94024-5637
Phone (650) 231-4835
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 |
|---|---|---|---|---|
| I20150626000351 | CA | Practitioner - Clinical Psychologist | 4486965878 | Practice locations: Los Altos, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 24355 | CA | Yes |
Addresses
Primary practice location
881 Fremont Ave
Suite B8
Los Altos, CA 94024-5697
Mailing address
PO Box 3763
Los Altos, CA 94024-0763
Phone (650) 231-4835
Other providers in Los Altos, CA
- Breathe Holistic Health, Inc.
- Theresa Dagondon Brinkman
- Raziel Elohima-Rizzo Brisbane
- Kevin Doyle Brock
- Ryan Canaan Broms
- Lloyd Brown
- Peter Watson Brown
- Sarah M Brown
- Bryan S. Lee MD Inc.
- William Maxwell Buchholz
All providers in Los Altos, 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, 2011. 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.