Individual provider Active NPI

Richard Jeffrey Weiss, PH.D.

  • Clinical Psychologist
  • Burlingame, CA
National Provider Identifier
1508934910
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY8377 Issued in CA
Practice address
1860 El Camino Real
#310
Burlingame, CA 94010-3127
Phone
(650) 697-8384
Fax
(650) 697-3931
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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 PSY8377 CA Primary

Addresses

Primary practice location

1860 El Camino Real
#310
Burlingame, CA 94010-3127

Mailing address

1860 El Camino Real
#310
Burlingame, CA 94010-3127
Phone (650) 697-8384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2018 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY8377CAMDClinical Psychologist
8377CAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1508934910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 EL CAMINO REAL",
            "address_2": "#310",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103127",
            "telephone_number": "650-697-8384",
            "fax_number": "650-697-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 EL CAMINO REAL",
            "address_2": "#310",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103127",
            "telephone_number": "650-697-8384",
            "fax_number": "650-697-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "RICHARD",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.