Organization Active NPI

Cognitive Behavior Therapy Center

  • Clinical Psychologist
  • San Rafael, CA
National Provider Identifier
1962587568
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4132 Issued in CA
Legal business name
COGNITIVE BEHAVIOR THERAPY CENTER
Practice address
990 A St
Suite 401
San Rafael, CA 94901-3042
Phone
(415) 456-2463
Fax
(415) 785-8956
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Dr. Paul Rochester Munford, PH.D.
Title
Clinical Psychologist & Director
Phone
(415) 456-2463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY4132 CA Primary

Addresses

Primary practice location

990 A St
Suite 401
San Rafael, CA 94901-3042

Mailing address

990 A St
Suite 401
San Rafael, CA 94901-3042
Phone (415) 456-2463

National Provider Directory

National Provider Directory

Locations

990 A St
Ste 401
San Rafael, CA 94901
Phone (415) 456-2463

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1962587568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 A ST",
            "address_2": "SUITE 401",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013042",
            "telephone_number": "415-456-2463",
            "fax_number": "415-453-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 A ST",
            "address_2": "SUITE 401",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013042",
            "telephone_number": "415-456-2463",
            "fax_number": "415-785-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE BEHAVIOR THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "MUNFORD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ROCHESTER",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST & DIRECTOR",
        "authorized_official_telephone_number": "415-456-2463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4132",
            "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 Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.