Individual provider Active NPI

Dacoda Rain Todoran, PSYD

  • Clinical Psychologist
  • Fremont, CA
National Provider Identifier
1790213304
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33051 Issued in CA
Practice address
39350 Civic Center Dr
Fremont, CA 94538-2343
Phone
(408) 494-4000
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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 33051 CA Primary

Addresses

Primary practice location

39350 Civic Center Dr
Fremont, CA 94538-2343

Mailing address

4001 Ingot St
Fremont, CA 94538-6455

Other practice location 1

4001 Ingot St
Fremont, CA 94538-6455
Phone (408) 540-4431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33051CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1790213304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 INGOT ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945386455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382343",
            "telephone_number": "408-494-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Ingot St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945386455",
            "country_code": "US",
            "telephone_number": "408-540-4431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODORAN",
        "first_name": "DACODA",
        "middle_name": "RAIN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.