Simon Kiyoshi Hara

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1330 Lincoln Ave.
#201 Community Institute for Psychotherapy
San Rafael, CA 99401-2141

Phone

(415) 459-5999

Fax

(415) 459-5602

NPI assigned

Apr 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Institute for Psychotherapy

  • Voluntary or Charitable Agency
  • San Rafael, CA
  • NPI 1760403794
  NPD (past)
• Community Institute for Psychotherapy

  • Community/Behavioral Health Agency
  • San Rafael, CA
  • NPI 1780995258
  NPD (past)

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1285166736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VENTURA AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947062529",
            "telephone_number": "510-220-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE.",
            "address_2": "#201 COMMUNITY INSTITUTE FOR PSYCHOTHERAPY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "994012141",
            "telephone_number": "415-459-5999",
            "fax_number": "415-459-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARA",
        "first_name": "SIMON",
        "middle_name": "KIYOSHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Catherine Hanson, M.D.
• Mark Hanson
• Rick Hanson, PH.D.
• Stephanie Hanton, PHARM.D.
• Kyle Hara, LPCC
• Ryan Michael Harder, SUDRC MCPSS
• Aubrey Harmon
• Egda Haro
• Debra Harraka, DC
• Margaret Harrington, M.D.

• Student in an Organized Health Care Education/Training Program in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.