Individual provider Active NPI

Yanina Gonzales Blanchard, PSYD

  • Clinical Psychologist
  • Brookline, MA
National Provider Identifier
1497985444
Registry record updated Aug 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9900 Issued in MA
Practice address
1371 Beacon St
Suite 304
Brookline, MA 02446-4905
Phone
(617) 232-2435
Fax
(617) 232-0078
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2016

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 9900 MA Primary

Addresses

Primary practice location

1371 Beacon St
Suite 304
Brookline, MA 02446-4905

Mailing address

1371 Beacon St
Suite 304
Brookline, MA 02446-4905
Phone (617) 232-2435

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

LicenseStateTypeSpecialty
9900MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471651200000",
    "number": "1497985444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST",
            "address_2": "SUITE 304",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-232-2435",
            "fax_number": "617-232-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST",
            "address_2": "SUITE 304",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-232-2435",
            "fax_number": "617-232-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "YANINA",
        "middle_name": "GONZALES",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2016-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.