Active NPI
Bert Hildan Epstein
- Clinical Psychologist
- Petaluma, CA
National Provider Identifier
1346546173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY21404
- Practice address
- 115 Liberty St Ste 5
Petaluma, CA 94952-2320 - Phone
- (707) 242-1989
- NPI assigned
- Jan 26, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY21404 | CA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY21404 | CA | |
| Clinical Psychologist | 103TC0700X | PSY21404 | CA | Primary |
Addresses
Primary practice location
115 Liberty St Ste 5
Petaluma, CA 94952-2320
Mailing address
45 Adams LN
Petaluma, CA 94952-4766
Phone (916) 709-6899
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21404 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1346546173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 ADAMS LN",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949524766",
"telephone_number": "916-709-6899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 LIBERTY ST STE 5",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949522320",
"telephone_number": "707-242-1989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EPSTEIN",
"first_name": "BERT",
"middle_name": "HILDAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-26",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY21404",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "PSY21404",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY21404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
- Embracing Life Psychotherapy Inc.
- Brooklyn Emery
- Caleb England
- Ioana Ramona English
- Ensign Sahota, LLC
- Erin Byous Marriage and Family Therapist, Professional Corporation
- Erin Byous, MFT Licensed Marriage and Family Therapist
- Raymond Edward Erny, M.D.
- Alisa Renee Espana, MA, BCBA
- Asusena Esparza Rios, PT, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.