Wellspring Psychotherapy Center

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY14624 Issued in CA

Legal business name

WELLSPRING PSYCHOTHERAPY CENTER

Practice address

30 N San Pedro Rd Ste 290
San Rafael, CA 94903-4133

Phone

(415) 458-3358

NPI assigned

Sep 7, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Simone Rodin, PH.D.NPI 1285961755

Title

Director

Phone

(415) 458-3358

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Simone Rodin, PH.D.

  • Clinical Psychologist
  • San Rafael, CA
  • NPI 1285961755
  NPD Authorized official

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1083132310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N SAN PEDRO RD STE 290",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034133",
            "telephone_number": "415-458-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N SAN PEDRO RD STE 290",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034133",
            "telephone_number": "415-458-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING PSYCHOTHERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RODIN",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-458-3358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY14624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Weir, PH.D.
• Susan Margaret Weiss, R.D.
• Jodi Weitz, L.AC
• Ona Weizmann, PH.D.
• Barbara Jeanne Weldon, DC
• Tiarre Diana Welsh, MS., MFTI
• Barbara Welter, M.S.
• Stephen Edward Welter, M.D.
• Hui-Shan A. Wen, DO
• Lauren Foley Wenderoth, RD

• Psychologist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.