Active NPI
Cynthia Lynn-Noss Mataraso, PSYCHOLOGIST
- Clinical Psychologist
- Concord, CA
National Provider Identifier
1063696409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 17258
- Practice address
- 2827 Concord Blvd
Concord, CA 94519-2608 - Phone
- (925) 685-9670
- Fax
- (925) 685-1528
- NPI assigned
- Dec 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 17258 | CA | Primary |
Addresses
Primary practice location
2827 Concord Blvd
Concord, CA 94519-2608
Mailing address
2827 Concord Blvd
Concord, CA 94519-2608
Phone (925) 685-9670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 25, 2020 through Sep 25, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Step Forward | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Concord, CA
- NPI 1922203165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600387200000",
"number": "1063696409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2827 CONCORD BLVD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945192608",
"telephone_number": "925-685-9670",
"fax_number": "925-685-1528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2827 CONCORD BLVD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945192608",
"telephone_number": "925-685-9670",
"fax_number": "925-685-1528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATARASO",
"first_name": "CYNTHIA",
"middle_name": "LYNN-NOSS",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-20",
"last_updated": "2020-09-18",
"certification_date": "2020-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "17258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.