DR. ANDREA TABUENCA (PHD) – Clinical Child & Adolescent Psychologist, NPI 1093192874

DR. ANDREA TABUENCA (PHD) is a healthcare provider. based in Palo alto, California. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. PSY28819 (CA). The NPI Number for DR. ANDREA TABUENCA (PHD) is 1093192874

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANDREA TABUENCA (PHD)
NPI
1093192874
Phone
Not provided
Address
1804 EMBARCADERO RD
Enumeration Date
30 April 2015
Last Update Date
13 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3108259989
Graduation Year
2015 (11 years ago)
PAC ID
7517247216
Group Practice PAC ID
0749180453
Professional Enrollment ID
I20161215001987
Address ID
CA900956968LO300XXPLZX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:11State licenses:1Digital endpointsOther names

4,434 CLINICAL PSYCHOLOGIST in CA

Provider Addresses for DR. ANDREA TABUENCA (PHD)

  • 1804 EMBARCADERO RD

    SUITE 100

    PALO ALTO, CA 943033341

    Phone:

    Type: Mailing

  • 401 QUARRY RD

    MC 5719

    PALO ALTO, CA 943041419

    Phone: (650) 498-9111

    Type: Location

  • 5767 W CENTURY BLVD STE 400

    LOS ANGELES, CA 900455631

    Phone:

    Type: Mailing

  • 760 WESTWOOD PLZ STE 47-417

    LOS ANGELES, CA 900951419

    Phone: (310) 825-6731

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-12-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161215001987IClinical PsychologistCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749180453View full group profile

Reviews

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Frequently asked questions

Does DR. ANDREA TABUENCA (PHD) have a public NPI I can cite?
Public records show DR. ANDREA TABUENCA (PHD) under NPI 1093192874.
Does the public listing show DR. ANDREA TABUENCA (PHD) as active?
DR. ANDREA TABUENCA (PHD)'s NPI record reflects an active status in NPPES.
What services align with DR. ANDREA TABUENCA (PHD)'s listing?
DR. ANDREA TABUENCA (PHD)'s public classification highlights Clinical Child & Adolescent Psychologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. ANDREA TABUENCA (PHD)?
DR. ANDREA TABUENCA (PHD) is associated with Palo Alto, California in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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