Individual provider Active NPI

Marc Charles Weinberger, PH.D.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1477600377
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12475 Issued in CA
Practice address
879 14TH St
San Francisco, CA 94114-1211
Phone
(415) 863-4494
Fax
(415) 863-4494
NPI assigned
Jan 4, 2007
Sex
Male
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 PSY12475 CA Primary

Addresses

Primary practice location

879 14TH St
San Francisco, CA 94114-1211

Mailing address

879 14TH St
San Francisco, CA 94114-1211
Phone (415) 863-4494

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
I20120213000828 CA Practitioner - Clinical Psychologist 8426215872 Practice locations: Long Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2999 E Ocean Blvd
Unit 1320
Long Beach, CA 90803-8221
Phone (415) 902-6064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY12475CAMDClinical Psychologist
12475CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477600377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 14TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141211",
            "telephone_number": "415-863-4494",
            "fax_number": "415-863-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "879 14TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141211",
            "telephone_number": "415-863-4494",
            "fax_number": "415-863-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBERGER",
        "first_name": "MARC",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.