Individual provider Active NPI

Robin Yeganeh, PH.D.

  • Cognitive & Behavioral Psychologist
  • San Ramon, CA
National Provider Identifier
1962757351
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
PSY21202 Issued in CA
Practice address
111 Deerwood Rd
Suite 395
San Ramon, CA 94583-4409
Phone
(925) 984-8337
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PSY21202 CA Primary

Addresses

Primary practice location

111 Deerwood Rd
Suite 395
San Ramon, CA 94583-4409

Mailing address

548 Market St, PMB 99338
San Francisco, CA 94104-5401
Phone (925) 400-9604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 2, 2015 through Jul 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY21202CAMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1962757351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 MARKET ST, PMB 99338",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941045401",
            "telephone_number": "925-400-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD RD",
            "address_2": "SUITE 395",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834409",
            "telephone_number": "925-984-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEGANEH",
        "first_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY21202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.