Individual provider Active NPI

Maria Taheny, PHD

  • Clinical Psychologist
  • Antelope, CA
National Provider Identifier
1386095263
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY35188 Issued in CA
Practice address
4512 Winje Dr
Antelope, CA 95843-6033
Phone
(916) 980-6445
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY35188 CA Primary

Addresses

Primary practice location

4512 Winje Dr
Antelope, CA 95843-6033

Mailing address

4512 Winje Dr
Antelope, CA 95843-6033
Phone (916) 980-6445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250911004477 CA Practitioner - Clinical Psychologist 7618470956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Support for Your LifeGroup PAC ID 9638518467, 3 clinicians

Practice addresses (Care Compare)

701 High St
Suite 227
Auburn, CA 95603-4727
Phone (530) 500-5885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY35188CAMDClinical Psychologist
35188CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Support for Your Life Clinical CurrentSince Jun 5, 2025 Accepting new patients
Authentic Counseling Associates - a Psychological Corporation PastSince May 23, 2019 Accepting new patients

Locations

1111 High St
Ste B
Auburn, CA 95603

701 High St
Ste 227
Auburn, CA 95603
Phone (530) 500-5885

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1386095263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 WINJE DR",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958436033",
            "telephone_number": "916-980-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 WINJE DR",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958436033",
            "telephone_number": "916-980-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHENY",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antelope, CA

Sources for this page

Verify at the official NPI Registry.