Individual provider Active NPI

Alvin Raja Hornstein, PSY.D.

  • Clinical Psychologist
  • San Rafael, CA
National Provider Identifier
1386700136
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
21271 Issued in CA
Practice address
1330 Lincoln Ave
Suite 310
San Rafael, CA 94901-2143
Phone
(415) 779-2499
NPI assigned
Dec 28, 2006
Last updated
Jun 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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 21271 CA Primary

Addresses

Primary practice location

1330 Lincoln Ave
Suite 310
San Rafael, CA 94901-2143

Mailing address

PO Box 761
Kentfield, CA 94914-0761
Phone (415) 779-2499

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
I20070403000681 CA Practitioner - Clinical Psychologist 3577667336 Practice locations: Kentfield, CA; San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1330 Lincoln Ave
Suite 310
San Rafael, CA 94901-2143
Phone (415) 779-2499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1386700136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 761",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949140761",
            "telephone_number": "415-779-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE",
            "address_2": "SUITE 310",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012143",
            "telephone_number": "415-779-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNSTEIN",
        "first_name": "ALVIN",
        "middle_name": "RAJA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "21271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.