Paul R Puccinelli

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

15 Austin Ave
San Anselmo, CA 94960-2924

Phone

(415) 342-2839

NPI assigned

Sep 9, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1689956286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 AUSTIN AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602924",
            "telephone_number": "415-342-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 AUSTIN AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602924",
            "telephone_number": "415-342-2839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Saint Vincents Dr",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949031504",
            "country_code": "US",
            "telephone_number": "415-507-4262",
            "fax_number": "415-444-0532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCCINELLI",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Blade Pietila
• Amy Pillitteri, LCSW, PPSC
• Pine Street Clinic LLC
• Pornprapa Preamaboot, DPT
• Pilar Prime
• Vito W Pumo, RPH
• Gabriel F Rabu, LMFT
• Olivia Ramsay
• Audrey Ray, C.M.T
• Jennifer Hase Rice, PH.D.

• Marriage & Family Therapist in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.