Individual provider Active NPI

Gayathri Marini Perera, PH.D.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1457371205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20928 Issued in CA
Practice address
244 Myrtle St
San Francisco, CA 94109-6838
Phone
(510) 667-9996
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY20928 CA Primary

Addresses

Primary practice location

244 Myrtle St
San Francisco, CA 94109-6838

Mailing address

14728 Saturn Dr
San Leandro, CA 94578-1347
Phone (510) 667-9199

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
I20070215000281 CA Practitioner - Clinical Psychologist 9638171978 Practice locations: Castro Valley, CA; Pleasanton, CA; San Francisco, CA; San Leandro, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1000 E 14TH St
San Leandro, CA 94577-3787
Phone (510) 677-9996

2456 Bush St
San Francisco, CA 94115-3106
Phone (510) 667-9996

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY20928CAMDClinical Psychologist
20928CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457371205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14728 SATURN DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781347",
            "telephone_number": "510-667-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 MYRTLE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096838",
            "telephone_number": "510-667-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERERA",
        "first_name": "GAYATHRI",
        "middle_name": "MARINI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.