Individual provider Active NPI

Heidi Klein Minnick, PH.D.

  • Clinical Psychologist
  • Corte Madera, CA
National Provider Identifier
1093801821
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12381 Issued in CA
Practice address
21 Tamal Vista Blvd.
Suite 218
Corte Madera, CA 94925
Phone
(415) 457-1793
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY12381 CA
Clinical Psychologist 103TC0700X PSY12381 CA Primary

Addresses

Primary practice location

21 Tamal Vista Blvd.
Suite 218
Corte Madera, CA 94925

Mailing address

3 Madrone Ave.
Kentfield, CA 94904
Phone (415) 457-1793

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220001754 CA Practitioner - Clinical Psychologist 8729422563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Strategies Inc a Psychological CorpGroup PAC ID 0446144497, 23 clinicians

Practice addresses (Care Compare)

1160 N Dutton Ave
Suite 230
Santa Rosa, CA 95401-4658
Phone (707) 303-3201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12381CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp Psychologist CurrentSince Jan 1, 2024 Accepting new patients

Locations

1160 N Dutton Ave
Ste 230
Santa Rosa, CA 95401
Phone (707) 303-3201

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1093801821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MADRONE AVE.",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "94904",
            "telephone_number": "415-457-1793",
            "fax_number": "415-485-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD.",
            "address_2": "SUITE 218",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "94925",
            "telephone_number": "415-457-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "HEIDI",
        "middle_name": "KLEIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12381",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corte Madera, CA

Sources for this page

Verify at the official NPI Registry.