Michael Edward Buckle, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

30518 Issued in CA

Practice address

401 Quarry Rd
Palo Alto, CA 94304-1419

Phone

(650) 743-3269

NPI assigned

Jun 6, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2021 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychology Works of California PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Carlos, CA
  • NPI 1164137915
  NPD Authorized official

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1891287678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 GREENWOOD AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940704502",
            "telephone_number": "650-743-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041419",
            "telephone_number": "650-743-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLE",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "30518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynne Bryson, PHARM.D.
• Tatiana Buch
• Jillian Gwen Buchan, PH.D.
• Bet Buchanan, LMFT
• James Buck, DPT
• Julie Buckley, MD
• Cyrus Appietse Buckman
• Ashley Dale Buckner, LCSW
• Lauren Angela Buckwalter, APRN, FNP-BC
• Caroline Katharine Buckway, MD

• Psychologist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.

Verify at the official NPI Registry.