Individual provider Active NPI

Erin Kay Riley, PH.D.

  • Psychologist
  • Sebastopol, CA
National Provider Identifier
1902824386
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY15354 Issued in CA
Practice address
435 Petaluma Ave
Suite #140
Sebastopol, CA 95472-4277
Phone
(707) 829-2509
Fax
(707) 829-3170
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY15354 CA Primary

Addresses

Primary practice location

435 Petaluma Ave
Suite #140
Sebastopol, CA 95472-4277

Mailing address

435 Petaluma Ave
Suite #140
Sebastopol, CA 95472-4277
Phone (707) 829-2509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041026001190 CA Practitioner - Clinical Psychologist 3779544366 Practice locations: Sebastopol, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6761 Sebastopol Ave
Suite 111
Sebastopol, CA 95472-3837
Phone (707) 829-2509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15354CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp Psychologist PastSince Aug 1, 2002 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902824386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 PETALUMA AVE",
            "address_2": "SUITE #140",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724277",
            "telephone_number": "707-829-2509",
            "fax_number": "707-829-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PETALUMA AVE",
            "address_2": "SUITE #140",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724277",
            "telephone_number": "707-829-2509",
            "fax_number": "707-829-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "ERIN",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY15354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

Verify at the official NPI Registry.