Active NPI
Natalie Ma
- Clinical Psychologist
- San Rafael, CA
National Provider Identifier
1477710754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25231
- Practice address
- 155 Andersen Dr
2211
San Rafael, CA 94901-3993 - Phone
- (415) 305-3803
- NPI assigned
- May 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Psychologist | 103TC0700X | 25231 | CA | Primary |
Addresses
Primary practice location
155 Andersen Dr
2211
San Rafael, CA 94901-3993
Mailing address
155 Andersen Dr
2211
San Rafael, CA 94901-3993
Phone (415) 305-3803
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1477710754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 ANDERSEN DR",
"address_2": "2211",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013993",
"telephone_number": "415-305-3803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 ANDERSEN DR",
"address_2": "2211",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013993",
"telephone_number": "415-305-3803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MA",
"first_name": "NATALIE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-22",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "25231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.