MIND AND BODY PSYCHOLOGICAL SERVICES, PC
NPI 1134799786
Psychologist - Clinical in San Francisco, CA

Q: What is Mind And Body Psychological Services, PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since June 27, 2021

2409 19TH AVE STE B4, SAN FRANCISCO, CA 94116(415) 710-4879(415) 564-3167 Get Directions Write a Review

NPPES record last updated: June 27, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Mind And Body Psychological Services, Pc NPPES

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

MIND AND BODY PSYCHOLOGICAL SERVICES, PC (NPI 1134799786) is a healthcare organization registered as a clinical in San Francisco, California and active in the NPI registry since June 2021. The organization lists Tatiana Doubnova, Psychologist, as its authorized official.

NPPES Registry Identity

NPI1134799786

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameMIND AND BODY PSYCHOLOGICAL SERVICES, PC

Location Address2409 19TH AVE STE B4San Francisco, CA 94116-2495

Mailing Address2409 19th Ave Ste B4San Francisco, CA 94116-2495 · (415) 710-4879 · Fax (415) 564-3167

Phone(415) 710-4879

Fax(415) 564-3167

Organization SubpartNo

Authorized OfficialTatiana DoubnovaPsychologist · (415) 710-4879

Enumeration DateJune 27, 2021

NPPES CertifiedAugust 7, 2020

✔ NPI 1134799786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

2409 19TH AVE STE B4, San Francisco, CA 94116

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mind And Body Psychological Services, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mind And Body Psychological Services, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tatiana Doubnova, PSY.D.

Clinical Psychologist

NPI 1790957280

1204 VICENTE ST
San Francisco, CA 94116

(415) 710-4879

✔ PECOS✔ Accepts Medicare0.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mind And Body Psychological Services, PC's NPI number?

The NPI number for Mind And Body Psychological Services, PC is 1134799786. It was assigned to this organization in the NPPES registry on June 27, 2021.

Where is Mind And Body Psychological Services, PC located?

Mind And Body Psychological Services, PC is located at 2409 19th Ave Ste B4, San Francisco, CA 94116. The listed phone number is (415) 710-4879.

What is Mind And Body Psychological Services, PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mind And Body Psychological Services, PC enrolled in Medicare?

Yes. Mind And Body Psychological Services, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mind And Body Psychological Services, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mind And Body Psychological Services, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mind And Body Psychological Services, PC was last updated on June 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.