Individual provider Active NPI

Elizabeth Schreiber, PHD

  • Clinical Psychologist
  • Sebastopol, CA
National Provider Identifier
1942585575
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 24575 Issued in CA
Practice address
11000 Falstaff Rd
Sebastopol, CA 95472-9114
Phone
(707) 292-4836
NPI assigned
Oct 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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 24575 CA Primary

Addresses

Primary practice location

11000 Falstaff Rd
Sebastopol, CA 95472-9114

Mailing address

11000 Falstaff Rd
Sebastopol, CA 95472
Phone (707) 292-4836

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
I20120224000158 CA Practitioner - Clinical Psychologist 6507024353 Practice locations: Sebastopol, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11000 Falstaff Rd
Sebastopol, CA 95472-9114
Phone (707) 292-4836

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 24575CAMDClinical Psychologist
24575CAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lomi School Foundation PastSince Jan 10, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1942585575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 FALSTAFF RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472",
            "telephone_number": "707-292-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 FALSTAFF RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729114",
            "telephone_number": "707-292-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHREIBER",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-14",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 24575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

Verify at the official NPI Registry.