Individual provider Active NPI

Marley Mae Middlebrook, PSYD

  • Clinical Psychologist
  • Walnut Creek, CA
National Provider Identifier
1487778049
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 22606 Issued in CA
Practice address
5954 Autumnwood Dr Apt 2a
Walnut Creek, CA 94595-3918
Phone
(925) 352-1038
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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 PSY 22606 CA Primary

Addresses

Primary practice location

5954 Autumnwood Dr Apt 2a
Walnut Creek, CA 94595-3918

Mailing address

5954 Autumnwood Dr Apt 2a
Walnut Creek, CA 94595-3918
Phone (925) 352-1038

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
I20131104000214 CA Practitioner - Clinical Psychologist 1951449693 Practice locations: Walnut Creek, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1844 San Miguel Dr
Suite 311
Walnut Creek, CA 94596-4963
Phone (925) 352-1038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 22606CAMDClinical Psychologist
22606CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Center Inc PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1487778049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5954 AUTUMNWOOD DR APT 2A",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945953918",
            "telephone_number": "925-352-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5954 AUTUMNWOOD DR APT 2A",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945953918",
            "telephone_number": "925-352-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEBROOK",
        "first_name": "MARLEY",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.