Individual provider Active NPI

Julie Axelrod Austin, PSY.D.

  • Clinical Psychologist
  • Mill Valley, CA
National Provider Identifier
1104136506
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14898 Issued in CA
Practice address
240 Miller Ave Ste G
Mill Valley, CA 94941-2858
Phone
(415) 928-7800
NPI assigned
Oct 19, 2010
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY14898 CA Primary

Addresses

Primary practice location

240 Miller Ave Ste G
Mill Valley, CA 94941-2858

Mailing address

240 Miller Ave Ste G
Mill Valley, CA 94941-2858
Phone (415) 272-4515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY14898CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1104136506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MILLER AVE STE G",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412858",
            "telephone_number": "415-272-4515",
            "fax_number": "415-381-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MILLER AVE STE G",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412858",
            "telephone_number": "415-928-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "JULIE",
        "middle_name": "AXELROD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14898",
            "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 Oct 2, 2012; 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.