Active NPI
Wendy Eberhardt, MD
- Psychiatry Physician
- San Rafael, CA
National Provider Identifier
1184712531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G49305
- Practice address
- 42 Rhinestone Ter
San Rafael, CA 94903-1310 - Phone
- (415) 479-3357
- Fax
- (415) 472-4844
- NPI assigned
- Oct 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G49305 | CA | Primary |
Addresses
Primary practice location
42 Rhinestone Ter
San Rafael, CA 94903-1310
Mailing address
42 Rhinestone TR
San Rafael, CA 94903-1301
Phone (415) 479-3357
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49305 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Contra Costa County | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184712531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 RHINESTONE TR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031301",
"telephone_number": "415-479-3357",
"fax_number": "415-472-4844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 RHINESTONE TER",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031310",
"telephone_number": "415-479-3357",
"fax_number": "415-472-4844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERHARDT",
"first_name": "WENDY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G49305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.