Individual provider Active NPI

Libby Pearce

  • Clinical Psychologist
  • Fremont, CA
National Provider Identifier
1043473051
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26090 Issued in CA
Practice address
39420 Liberty St
Suite 140
Fremont, CA 94538-2200
Phone
(510) 745-9151
NPI assigned
Jul 9, 2008
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY26090 CA Primary

Addresses

Primary practice location

39420 Liberty St
Suite 140
Fremont, CA 94538-2200

Mailing address

39420 Liberty St
Suite 140
Fremont, CA 94538-2200
Phone (510) 745-9151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140317001511 CA Practitioner - Clinical Psychologist 0547491524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portia Bell Hume Behavioral Health and Training CenterGroup PAC ID 0547251688, 11 clinicians

Practice addresses (Care Compare)

1333 Willow Pass Rd
Suite 102
Concord, CA 94520-5225
Phone (925) 825-1793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY26090CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Portia Bell Hume Behavioral Health & Training Center CurrentSince Dec 7, 2013 Accepting new patients
Portia Bell Hume Behavioral Health and Training Center CurrentSince Dec 7, 2013 Accepting new patients
Portia Bell Hume Behavioral Health and Training Center Current Accepting new patients

Locations

1333 Willow Pass Rd
Ste 102
Concord, CA 94520
Phone (925) 338-7928

39420 Liberty St
Ste 140
Fremont, CA 94538
Phone (510) 464-4534

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1043473051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39420 LIBERTY ST",
            "address_2": "SUITE 140",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382200",
            "telephone_number": "510-745-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39420 LIBERTY ST",
            "address_2": "SUITE 140",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382200",
            "telephone_number": "510-745-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARCE",
        "first_name": "LIBBY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2008-07-09",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.