Individual provider Active NPI

Sarah Marie Centeno, MD

  • Psychiatry Physician
  • Kentfield, CA
National Provider Identifier
1366409922
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD20050147 Issued in NM
Practice address
1030 Sir Francis Drake Blvd
Suite 100, RM 1
Kentfield, CA 94904-1411
Phone
(415) 927-7097
Fax
(415) 449-3532
NPI assigned
Apr 27, 2006
Last updated
Feb 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD20050147 NM Primary

Addresses

Primary practice location

1030 Sir Francis Drake Blvd
Suite 100, RM 1
Kentfield, CA 94904-1411

Mailing address

1030 Sir Francis Drake Blvd
Suite 100, RM 1
Kentfield, CA 94904-1411
Phone (415) 927-7097

Other identifiers 1

IdentifierTypeStateIssuer
33655731MedicaidNM

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD20050147NMMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1366409922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SIR FRANCIS DRAKE BLVD",
            "address_2": "SUITE 100, RM 1",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041411",
            "telephone_number": "415-927-7097",
            "fax_number": "415-449-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SIR FRANCIS DRAKE BLVD",
            "address_2": "SUITE 100, RM 1",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041411",
            "telephone_number": "415-927-7097",
            "fax_number": "415-449-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTENO",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "MD20050147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33655731",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.