Active NPI
Jillian Tessier, PHD
- Psychologist
- Mill Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY34187
- Practice address
- 100 Shoreline Hwy
Building B, Suite 100
Mill Valley, CA 94941 - Phone
- (415) 877-4408
- NPI assigned
- Jul 12, 2023
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY34187 | CA | Primary |
Addresses
Primary practice location
100 Shoreline Hwy
Building B, Suite 100
Mill Valley, CA 94941
Mailing address
100 Shoreline Hwy
Building B, Suite 100
Mill Valley, CA 94941
Phone (415) 877-4408
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Shoreline Hwy
Suite B386
Mill Valley, CA 94941-6609
Phone (415) 877-4408
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY34187 | CA | MD | Psychologist |
| 34187 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K&M Neuropsychology, a Psychology Corporation | Current | Accepting new patients | |
| California Pacific Medical Group, Inc. | Past | Accepting new patients |
Locations
100 Shoreline Hwy
Ste B386
Mill Valley, CA 94941
Phone (415) 877-4408
100 Shoreline Hwy
Ste B100
Mill Valley, CA 94941
Phone (415) 877-4408
100 Shoreline Hwy
Ste 100
Mill Valley, CA 94941
Phone (408) 410-3671
Organizations & group practices 2
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.
-
- Clinic/Center
- Mill Valley, CA
- NPI 1760900831
-
- Multi-Specialty Clinic/Center
- Oakland, CA
- NPI 1275002453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1093494544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 SHORELINE HWY",
"address_2": "BUILDING B, SUITE 100",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "94941",
"telephone_number": "415-877-4408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SHORELINE HWY",
"address_2": "BUILDING B, SUITE 100",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "94941",
"telephone_number": "415-877-4408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESSIER",
"first_name": "JILLIAN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-12",
"last_updated": "2023-07-12",
"certification_date": "2023-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY34187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mill Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.