TRACY BROOKE RYARU PH.D.
NPI 1073714689
Psychologist in Kentfield, CA

Active since May 30, 2007Opted out of Medicare · through Apr 1, 2027
1044 SIR FRANCIS DRAKE BLVD STE 4, KENTFIELD, CA 94904(415) 721-3344 Get Directions Write a Review

NPPES record last updated: July 22, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tracy Brooke Ryaru Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACY BROOKE RYARU PH.D. (NPI 1073714689) is an individual psychologist in Kentfield, California, licensed in California (PSY 24226) and active in the NPI registry since May 2007. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1073714689
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameTRACY BROOKE RYARUCredential: PH.D.
Location Address1044 SIR FRANCIS DRAKE BLVD STE 4Kentfield, CA 94904-1454
Mailing Address1044 Sir Francis Drake Blvd Ste 4Kentfield, CA 94904-1454 · (415) 302-1522
Sole ProprietorYes
Enumeration DateMay 30, 2007
Last NPPES UpdateJuly 22, 2011
NPI 1073714689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY 24226
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1044 SIR FRANCIS DRAKE BLVD STE 4, Kentfield, CA 94904

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Tracy Brooke Ryaru Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2017 through April 1, 2027.

Opt-Out Effective DateApril 1, 2017
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinical Neuropsychologist
1044 SIR FRANCIS DRAKE BLVD STE 4
KENTFIELD, CA 94904

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tracy Ryaru's NPI number?

The NPI number for Tracy Ryaru is 1073714689. It was assigned to this individual provider in the NPPES registry on May 30, 2007.

Where is Tracy Ryaru located?

Tracy Ryaru practices at 1044 Sir Francis Drake Blvd Ste 4, Kentfield, CA 94904. The listed phone number is (415) 721-3344.

What is Tracy Ryaru's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Tracy Ryaru enrolled in Medicare?

No. Tracy Ryaru has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Tracy Ryaru was last updated on July 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.