Ebmc Psychology, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

EBMC PSYCHOLOGY, INC

Practice address

23 Altarinda Rd Ste 218
Orinda, CA 94563-2610

Phone

(925) 317-3179

NPI assigned

Feb 8, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Joshua Robert Wilson, MFT

Title

President

Phone

(925) 317-3179

Specialties & licenses 3

Addresses

Other names 1

• East Bay Mindfulness Center Doing business as

Locations

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1972961795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ALTARINDA RD STE 218",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632610",
            "telephone_number": "925-317-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ALTARINDA RD STE 218",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632610",
            "telephone_number": "925-317-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBMC PSYCHOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-317-3179",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Bay Mindfulness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Elaine Dombek
• Dr Kevin Wong DC Orinda Chiropractic Center PC
• East Bay Gynecologic Oncology
• East Bay Pediatrics Medical Group
• East Bay Physicians Medical Group
• John S. Edelen, M.D.
• Marlene Ingrid Ehlers, DC
• Sue N Elkind, PH.D.
• Encompass Connections
• Kristine M Eng, O.D.

• All providers in Orinda, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.