Mind and Body Psychological Services, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MIND AND BODY PSYCHOLOGICAL SERVICES, PC

Practice address

2409 19TH Ave Ste B4
San Francisco, CA 94116-2495

Phone

(415) 710-4879

Fax

(415) 564-3167

NPI assigned

Jun 27, 2021

Organization subpart

No

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

Authorized official

Name

Tatiana Doubnova, PSYDNPI 1790957280

Title

Psychologist

Phone

(415) 710-4879

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Tatiana Doubnova, PSY.D.

  • Clinical Psychologist
  • San Francisco, CA
  • NPI 1790957280
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1624752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624752000000",
    "number": "1134799786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 19TH AVE STE B4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162495",
            "telephone_number": "415-710-4879",
            "fax_number": "415-564-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 19TH AVE STE B4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162495",
            "telephone_number": "415-710-4879",
            "fax_number": "415-564-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND AND BODY PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-27",
        "last_updated": "2021-06-27",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "DOUBNOVA",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "415-710-4879",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tdoubnova@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2409 19th Ave Ste B4",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941162495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mika Minami
• Joseph Leonard Minardi
• Dzovag Minassian, M.D, MPH
• Charisse Minatoya
• Katherine Laureana Minaya, MD
• Trisha Kulkarni Mindel, A.S.W.
• Mindful Health Solutions a Professional Medical Corporation
• Mindful Living, a Marriage and Family Therapy Corporation
• Mindful Mental Wellness, P.a.
• Mindfulsf Marriage and Family Therapy Inc.

• 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 Jun 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.