Active NPI
Erin Michelle Hisae Yip, PSYD
- Clinical Psychologist
- Corte Madera, CA
National Provider Identifier
1801376264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY34143
- Practice address
- 21 Tamal Vista Blvd Ste 225
Corte Madera, CA 94925-1130 - Phone
- (415) 289-9280
- NPI assigned
- Aug 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY34143 | CA | Primary |
Addresses
Primary practice location
21 Tamal Vista Blvd Ste 225
Corte Madera, CA 94925-1130
Mailing address
21 Tamal Vista Blvd Ste 225
Corte Madera, CA 94925-1130
Phone (650) 430-5315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 14, 2024 through Feb 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY34143 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1801376264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 TAMAL VISTA BLVD STE 225",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251130",
"telephone_number": "650-430-5315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 TAMAL VISTA BLVD STE 225",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251130",
"telephone_number": "415-289-9280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YIP",
"first_name": "ERIN",
"middle_name": "MICHELLE HISAE",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY34143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corte Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.