Individual provider Active NPI

Bruce Gerard Hiner, PSY.D.

  • Clinical Psychologist
  • Sebastopol, CA
National Provider Identifier
1922119809
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 19229 Issued in CA
Practice address
120 Pleasant Hill Ave N Ste 340
Sebastopol, CA 95472-3168
Phone
(707) 329-6942
Fax
(844) 276-4833
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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 PSY 19229 CA Primary

Addresses

Primary practice location

120 Pleasant Hill Ave N Ste 340
Sebastopol, CA 95472-3168

Mailing address

120 Pleasant Hill Ave N Ste 340
Sebastopol, CA 95472-3168
Phone (707) 329-6942

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
I20090319000566 CA Practitioner - Clinical Psychologist 8527125400 Practice locations: Sebastopol, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

120 Pleasant Hill Ave N
Suite 340
Sebastopol, CA 95472-3168
Phone (707) 329-6942

120 Pleasant Hill N Ave
Suite 340
Sebastopol, CA 95472-3168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 19229CAMDClinical Psychologist
19229CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1922119809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PLEASANT HILL AVE N STE 340",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723168",
            "telephone_number": "707-329-6942",
            "fax_number": "844-276-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PLEASANT HILL AVE N STE 340",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723168",
            "telephone_number": "707-329-6942",
            "fax_number": "844-276-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINER",
        "first_name": "BRUCE",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 19229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

Verify at the official NPI Registry.