Unknown Individual – Clinical Psychologist, NPI 1881618692

Unknown Individual is a healthcare provider. based in San rafael, California. specializing in Clinical Psychologist. They hold a License No. PSY7175 (CA). The NPI Number for Unknown Individual is 1881618692

Main info

Organization
Inactive
46 Years Of Experience
Name
Unknown Individual
NPI
1881618692
Phone
(415) 457-9227
Address
1330 LINCOLN AVE
Deactivation Date
24 February 2022

Doctor Profile

Medical School Name
BERKELEY NORTHEASTERN STATE UNIVERSITY - COLLEGE OF MEDICINE
Secondary Phone
4154579227
Graduation Year
1980 (46 years ago)
PAC ID
3375715626
Professional Enrollment ID
I20111010000044
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1330, Lincoln Avenue, San Rafael, Marin County, California, 94901, United States

    105

    SAN RAFAEL, CA 949012120

    Phone: (415) 457-9227

    Fax: (415) 457-9227

    Mailing address matches the actual address.

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.

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Medicare Enrollment & Revalidation

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

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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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 94901)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1881618692 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near San Rafael, California may find Unknown Individual in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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