Tom Peabody, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY15343 Issued in CA

Practice address

345 Lorton Ave
Suite 104
Burlingame, CA 94010-4133

Phone

(650) 634-9807

Fax

(650) 348-3087

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1144306218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 LORTON AVE",
            "address_2": "SUITE 104",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104133",
            "telephone_number": "650-634-9807",
            "fax_number": "650-348-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 LORTON AVE",
            "address_2": "SUITE 104",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104133",
            "telephone_number": "650-634-9807",
            "fax_number": "650-348-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEABODY",
        "first_name": "TOM",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15343",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY15343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY153430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trushna Patel, M.D
• Pamela Patino Trier
• Marc Patricio
• Pauline Chau Nutrition, LLC
• Maria Pavlova, RD
• Pear Holdings, LLC
• Mark Newman Pederson, M.D.
• Jessie Peng, NP-C
• Peninsula Allergy Associates, a Medical Group Inc.
• Peninsula Child and Family Therapy Inc

• Psychologist in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.