NPIMap

Organization Active NPI

Community Institute for Psychotherapy

  • Community/Behavioral Health Agency
  • San Rafael, CA
National Provider Identifier
1780995258
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
X Issued in CA
Legal business name
COMMUNITY INSTITUTE FOR PSYCHOTHERAPY
Practice address
1330 Lincoln Ave
Suite 100
San Rafael, CA 94901-2120
Phone
(415) 459-5999
Fax
(415) 459-5602
NPI assigned
Jun 29, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Robin J Berenson, PH. D.
Title
Executive Clinical Director
Phone
(415) 459-5999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X X CA Primary

Addresses

Primary practice location

1330 Lincoln Ave
Suite 100
San Rafael, CA 94901-2120

Mailing address

1330 Lincoln Ave
Suite 201
San Rafael, CA 94901-2120
Phone (415) 459-5999

National Provider Directory

National Provider Directory
Tax ID family
Suny Buffalo140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

1330 Lincoln Ave
Ste 100
San Rafael, CA 94901
Phone (415) 260-9490

Practitioners & affiliated clinicians

Practitioners 136

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 136

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780995258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE",
            "address_2": "SUITE 201",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012120",
            "telephone_number": "415-459-5999",
            "fax_number": "415-459-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE",
            "address_2": "SUITE 100",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012120",
            "telephone_number": "415-459-5999",
            "fax_number": "415-459-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INSTITUTE FOR PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERENSON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "415-459-5999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.