Individual provider Active NPI

Miguel Keller Hidalgo-Barnes, PSY.D.

  • Clinical Psychologist
  • Richmond, CA
National Provider Identifier
1669656393
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY24974 Issued in CA
Practice address
3095 Richmond Pkwy
Ste 201
Richmond, CA 94806-5878
Phone
(510) 596-8125
NPI assigned
Dec 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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 PSY24974 CA Primary

Addresses

Primary practice location

3095 Richmond Pkwy
Ste 201
Richmond, CA 94806-5878

Mailing address

3095 Richmond Pkwy
Ste 201
Richmond, CA 94806-5878
Phone (510) 596-8125

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
I20130115000419 CA Practitioner - Clinical Psychologist 7416100813 Reassigns benefits to 1 organization
Practice locations: Richmond, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portia Bell Hume Behavioral Health and Training CenterGroup PAC ID 0547251688, 11 clinicians

Practice addresses (Care Compare)

1333 Willow Pass Rd
Suite 102
Concord, CA 94520-5225
Phone (925) 825-1793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24974CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Portia Bell Hume Behavioral Health & Training Center CurrentSince Jan 3, 2015 Accepting new patients
Portia Bell Hume Behavioral Health and Training Center Current Accepting new patients
Portia Bell Hume Behavioral Health and Training Center CurrentSince Jan 3, 2015 Accepting new patients
La Cheim School, Inc. PastSince Apr 14, 2013 Accepting new patients

Locations

1333 Willow Pass Rd
Ste 102
Concord, CA 94520
Phone (925) 338-7928

3095 Richmond Pkwy
Ste 201
San Pablo, CA 94806
Phone (510) 717-3159

Organizations & group practices 4

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": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1669656393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 RICHMOND PKWY",
            "address_2": "STE 201",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065878",
            "telephone_number": "510-596-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 RICHMOND PKWY",
            "address_2": "STE 201",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065878",
            "telephone_number": "510-596-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIDALGO-BARNES",
        "first_name": "MIGUEL",
        "middle_name": "KELLER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-17",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

Verify at the official NPI Registry.