Tracy Brooke Ryaru, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 24226 Issued in CA

Practice address

1044 Sir Francis Drake Blvd Ste 4
Kentfield, CA 94904-1454

Phone

(415) 721-3344

NPI assigned

May 30, 2007

Last updated

Jul 22, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1073714689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 SIR FRANCIS DRAKE BLVD STE 4",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041454",
            "telephone_number": "415-302-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 SIR FRANCIS DRAKE BLVD STE 4",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041454",
            "telephone_number": "415-721-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYARU",
        "first_name": "TRACY",
        "middle_name": "BROOKE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 24226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise Evette Robinson, MFT
• Christopher Roebken, D.D.S
• Curtis K. Roebken, MD
• Ross Valley Physical Therapy, Inc.
• Vannessa Lyn Rostchild
• Sanya Sahi, MSPT
• Jeffery Morgan Sammis, PSY.D
• San Quentin State Prison (san quentin prison)
• Diana Sanborn, PH.D.
• Steve Sanchez, PT

• Psychologist in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.