In Depth Psychotherapy and Wellness PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25119 Issued in CA

Legal business name

IN DEPTH PSYCHOTHERAPY AND WELLNESS PC

Practice address

333 Hayes St
Suite 104
San Francisco, CA 94102-4453

Phone

(415) 754-0451

NPI assigned

Jan 21, 2016

Organization subpart

No

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

Authorized official

Name

Marissa A Robinson, PSY.D

Title

Owner

Phone

41577540451

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1134586191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 FRUSTUCK AVE",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "949301906",
            "telephone_number": "415-754-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 HAYES ST",
            "address_2": "SUITE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941024453",
            "telephone_number": "415-754-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN DEPTH PSYCHOTHERAPY AND WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "41577540451",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.