Miriam Medlin Andrade, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23089 Issued in CA

Practice address

1421 Broderick St
San Francisco, CA 94115-3304

Phone

(415) 292-1760

NPI assigned

Nov 13, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1073684684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 TURNER DR",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945101417",
            "telephone_number": "415-860-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 BRODERICK ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153304",
            "telephone_number": "415-292-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "MIRIAM",
        "middle_name": "MEDLIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "RPS2006016",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SF CLINICIAN BILLING ID",
            "identifier": "9555",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexy Francisco Andrade, RN, MSN, FNP-C
• Daniel Paul Andrade, LCSW
• Ivania Andrade
• John Andrade, LCSW
• Lucy Maria Andrade, MS, CCC SLP
• Tiffany M Andrade
• Evette Andraos
• Andre F. Azarinfar DDS & Parisa Mosavian DDS, Inc
• Elizabeth Jean Andreacci
• Dennis Andreatta, RN, MSN, CRRN, PHN

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.