Active NPI
Danielle Rene Miyasato, PHD
- Clinical Psychologist
- Mill Valley, CA
National Provider Identifier
1528209954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY21712
- Practice address
- 150 Shoreline Hwy
Building B, Ste 22B
Mill Valley, CA 94941-3639 - Phone
- (415) 408-7488
- Fax
- (415) 408-7488
- NPI assigned
- Mar 16, 2009
- Last updated
- Sep 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY21712 | CA | Primary |
Addresses
Primary practice location
150 Shoreline Hwy
Building B, Ste 22B
Mill Valley, CA 94941-3639
Mailing address
357 Dolan Ave
Mill Valley, CA 94941-3823
Phone (619) 251-3808
Other names 1
- Dr. Danielle Rene Miyasato
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
- Opted out of Medicare
- Yes, effective Oct 1, 2019 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1528209954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357 DOLAN AVE",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949413823",
"telephone_number": "619-251-3808",
"fax_number": "415-408-7488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 SHORELINE HWY",
"address_2": "BUILDING B, STE 22B",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949413639",
"telephone_number": "415-408-7488",
"fax_number": "415-408-7488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIYASATO",
"first_name": "DANIELLE",
"middle_name": "RENE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-16",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY21712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DANIELLE",
"last_name": "MIYASATO",
"middle_name": "RENE",
"prefix": "DR.",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mill Valley, CA
- Mill Valley Physical Therapy Partnership (Mill Valley Physical Therapy)
- Mill Valley School District
- Zeljko Milovanovic, M.D.
- Natalie Alyssa Milton, DR
- Leslie Y Miya, MD
- Stephen P Mongiello, PT
- Allyson Gayle Moore, M.S., BCBA, LMFT
- Caitlin S. Moore, MA
- Mary Saunders Moore, LMFT
- Tammara J Moore, DPT, OCS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.