Active NPI
Irene McLoughlin, PSY.D
- Psychologist
- San Rafael, CA
National Provider Identifier
1306158910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY18149
- Practice address
- 104 Maywood Way
San Rafael, CA 94901-1132 - Phone
- (415) 835-2189
- NPI assigned
- Jul 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY18149 | CA | Primary |
Addresses
Primary practice location
104 Maywood Way
San Rafael, CA 94901-1132
Mailing address
104 Maywood Way
San Rafael, CA 94901-1132
Phone (415) 835-2189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111021000263 | CA | Practitioner - Psychologist Billing Independently | 6800068693 | Practice locations: San Rafael, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18149 | CA | MD | Psychologist |
| 18149 | CA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1306158910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 MAYWOOD WAY",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011132",
"telephone_number": "415-835-2189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 MAYWOOD WAY",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011132",
"telephone_number": "415-835-2189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLOUGHLIN",
"first_name": "IRENE",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-12",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY18149",
"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 Oct 14, 2020; 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.