T. Adelstein, PH.D., Psychologist, P.C.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

12543 Issued in CA

Legal business name

T. ADELSTEIN, PH.D., PSYCHOLOGIST, P.C.

Practice address

45 Windstone Dr
San Rafael, CA 94903-1438

Phone

(415) 381-2209

Fax

(415) 593-7789

NPI assigned

Mar 3, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Teddy Adelstein, PH.D.NPI 1144276874

Title

President

Phone

(415) 381-2209

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teddy Adelstein, PH.D.

  • Clinical Psychologist
  • San Rafael, CA
  • NPI 1144276874
  Medicare reassignment NPD Authorized official
• Joan W. Bonnar, PH.D.

  • Clinical Psychologist
  • San Francisco, CA
  • NPI 1912119058
  NPD (past)

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1669864302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 PEREGRINE AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160170",
            "telephone_number": "415-381-2209",
            "fax_number": "415-593-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WINDSTONE DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031438",
            "telephone_number": "415-381-2209",
            "fax_number": "415-593-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T. ADELSTEIN, PH.D., PSYCHOLOGIST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-03",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "ADELSTEIN",
        "authorized_official_first_name": "TEDDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-381-2209",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "12543",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "12543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rehan Ryan Mir Syed, MD, MSC
• Barbara J Sylvester, MSW LCSW
• Synergyhomecare Ca62
• Katalin Szabo
• Michael Szymanski
• Michelle Ta, DMD
• Michael Leander Tabb Sr.
• Michael S Taekman, M.D.
• Andrew Tai
• Angela Talamantez, OTR/L

• Psychologist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.