Active NPI
Marie-Nathalie Beaudoin, PSYCHOLOGIST
- Clinical Psychologist
- Cupertino, CA
National Provider Identifier
1447468558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 15892
- Practice address
- 21760 Stevens Creek Blvd Ste 102
Cupertino, CA 95014-1170 - Phone
- (408) 738-3343
- NPI assigned
- May 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 15892 | CA | Primary |
Addresses
Primary practice location
21760 Stevens Creek Blvd Ste 102
Cupertino, CA 95014-1170
Mailing address
819 Anshen CT
Sunnyvale, CA 94086-8583
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 |
|---|---|---|---|
| PSY 15892 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447468558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 ANSHEN CT",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940868583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21760 STEVENS CREEK BLVD STE 102",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950141170",
"telephone_number": "408-738-3343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUDOIN",
"first_name": "MARIE-NATHALIE",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 15892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cupertino, CA
- Bay Area Maternity Midwifery, Registered Nursing and Women's Health
- Bay Area Midwifery,Registered Nursing and Women's Health,PC (BayArea Midwifery and Women's Health)
- Kimberly Lynn Bayerbach, PHARMD
- Be Well Health LLC
- Bea Medical Group, Inc.
- Sara Jessica Beitler
- Diana Marie Belli, DDS
- Carla Zuleidi Beltran Solano
- Brenna Grace Bentley, CGC
- Dvora Varda Berger, RPT
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.