Individual provider Active NPI

Tracy O'Connor Schmidt, PH.D.

  • Psychologist
  • San Rafael, CA
National Provider Identifier
1275887903
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 14438 Issued in CA
Practice address
1346 4TH St
Suite 205
San Rafael, CA 94901-2860
Phone
(415) 995-0232
NPI assigned
Nov 2, 2012
Last updated
Nov 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 14438 CA Primary

Addresses

Primary practice location

1346 4TH St
Suite 205
San Rafael, CA 94901-2860

Mailing address

1346 4TH St
Suite 205
San Rafael, CA 94901-2860
Phone (415) 995-0232

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 14438CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1275887903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 4TH ST",
            "address_2": "SUITE 205",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012860",
            "telephone_number": "415-995-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 4TH ST",
            "address_2": "SUITE 205",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012860",
            "telephone_number": "415-995-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "TRACY",
        "middle_name": "O'CONNOR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 14438",
            "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 Nov 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.