North Bay Psychology

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23513 Issued in CA

Legal business name

NORTH BAY PSYCHOLOGY

Practice address

1763 2ND St
Napa, CA 94559-2407

Phone

(707) 556-2356

Fax

(707) 256-3553

NPI assigned

Mar 27, 2012

Organization subpart

No

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

Authorized official

Name

Pamela Meghan Tiedemann-Fuller, PHDNPI 1922186949

Title

Licensed Clinical Psychologist

Phone

(707) 556-2356

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Pamela Meghan Tiedemann-Fuller, PHD

  • Clinical Psychologist
  • Napa, CA
  • NPI 1922186949
  Medicare reassignment NPD Authorized official
• Cynthia Helene Colvin, PHD

  • Psychologist
  • Oakland, CA
  • NPI 1184840035
  NPD (past)
• Michael Steven Loose, MD

  • Psychiatry Physician
  • Napa, CA
  • NPI 1306864756
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1740556489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5524",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945810524",
            "telephone_number": "707-556-2356",
            "fax_number": "707-256-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1763 2ND ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945592407",
            "telephone_number": "707-556-2356",
            "fax_number": "707-256-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BAY PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "TIEDEMANN-FULLER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "MEGHAN",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "707-556-2356",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nazanin Nooraei, AUD
• Raichill Norgrove
• Christine Eileen Norris, RADT
• North Bay Allergy and Asthma
• North Bay Prosthetics and Orthotics LLC
• Northbay Napa Hospital Corp
• Northbay Prosthetics and Orthotics LLC
• Northern California Advanced Practice Nursing Services, Inc.
• Michael R Novak, MD
• Sacia Novak

• Clinical Psychologist in Napa, CA
• Providers in Napa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.