John B. Coyne, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY20173 Issued in CA

Practice address

200 Tamal PLZ Ste 130
Corte Madera, CA 94925-1195

Phone

(415) 322-3018

NPI assigned

Feb 6, 2007

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coyne Operated Psychotherapy Inc

  • Adult Mental Health Clinic/Center
  • Corte Madera, CA
  • NPI 1861264574
  NPD Authorized official
• City and County of San Francisco

  dba DSAAM OTOP Methadone Maintenance

  • Methadone Clinic
  • San Francisco, CA
  • NPI 1578787925
  NPD (past)
• University of California San Francisco

  dba UCSF SFGH CPG Psychiatry Program

  • Clinical Psychologist
  • San Francisco, CA
  • NPI 1104992817
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1326187907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 CENTER BLVD",
            "address_2": "PBM 125",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "94930",
            "telephone_number": "415-322-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TAMAL PLZ STE 130",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251195",
            "telephone_number": "415-322-3018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "769 Center Blvd",
            "address_2": "PBM 125",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "CA",
            "postal_code": "94930",
            "country_code": "US",
            "telephone_number": "415-322-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COYNE",
        "first_name": "JOHN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY20173",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY20173",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corte Madera Family Dentistry Inc.
• Corte Madera Rehab LLC
• Courageous Counseling Center
• Courageous Counseling Center
• Coyne Operated Psychotherapy Inc
• Valerie Crawford, PH.D.
• Jazmine Cunanan
• Mary Cunningham-Bryant, PH.D.
• Samantha Curiale, MFT
• Nicolette D'Esposito, MSOT, OTR/L

• Clinical Psychologist in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.