Active NPI
Sara Brooker
- Psychologist
- San Rafael, CA
National Provider Identifier
1821353541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 28204
- Practice address
- 111 Smith Ranch Rd
San Rafael, CA 94903-1939 - Phone
- (415) 491-3000
- NPI assigned
- Jul 9, 2012
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 28204 | CA | Primary |
Addresses
Primary practice location
111 Smith Ranch Rd
San Rafael, CA 94903-1939
Mailing address
708 Page St
San Francisco, CA 94117-2409
Phone (714) 348-2457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2023 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471219200000",
"number": "1821353541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 PAGE ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941172409",
"telephone_number": "714-348-2457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SMITH RANCH RD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031939",
"telephone_number": "415-491-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKER",
"first_name": "SARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-09",
"last_updated": "2016-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "28204",
"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 Aug 15, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.