Edgar O. Angelone, PH.D

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY13957 Issued in CA

Practice address

2154 4TH St
San Rafael, CA 94901-2650

Phone

(415) 457-3451

Fax

(415) 457-3819

NPI assigned

Dec 18, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Marin Neuropsychology and Psychological Center, PC

  • Clinical Neuropsychologist
  • San Rafael, CA
  • NPI 1003102393
  Authorized official Same address or phone
• Marin Neuropsychology Center - a Psychology Corporation

  • Clinical Neuropsychologist
  • San Rafael, CA
  • NPI 1588333686
  Authorized official Same address or phone
• Arv Assisted Living, Inc.

  dba Tamalpais Creek

  • Assisted Living Facility
  • Novato, CA
  • NPI 1679877500
  NPD (past)
• HSRC

  • Case Management Agency
  • Eureka, CA
  • NPI 1548681570
  NPD (past)
• Mt Diablo Memory Center, a Psychological Corporation

  • Psychologist
  • Walnut Creek, CA
  • NPI 1851537450
  NPD (past)
• Nazareth House

  • Skilled Nursing Facility
  • San Rafael, CA
  • NPI 1609877950
  NPD (past)
• Redwood Coast Pace

  • PACE Provider Organization
  • Eureka, CA
  • NPI 1649607664
  NPD (past)
• Vericare of California Medical Group

  • Clinical Psychologist
  • Paradise, CA
  • NPI 1316992829
  NPD (past)
• Powerback Rehabilitation LLC

  dba Powerback Rehabilitation

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407919988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 4TH ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012650",
            "telephone_number": "415-457-3451",
            "fax_number": "415-457-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 4TH ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012650",
            "telephone_number": "415-457-3451",
            "fax_number": "415-457-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELONE",
        "first_name": "EDGAR",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY13957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PSY13957",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Odysseus Andrianos, BS
• Julane Andries, LMFT
• Joseph Andris, DO
• Suha Anees
• Gurmeen Aneja
• Sonya Bolch Angelone, MS, RD, CLT
• Joey Angeloni, BS
• Angotti Healthcare Systems Inc
• Laila Ansari
• Ryan Gregory Ansari

• Clinical Neuropsychologist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.