DR. OMAR GABRIEL GUDINO PH.D., ABPP
NPI 1699899674
Psychologist - Clinical Child & Adolescent in San Mateo, CA

Q: What is Omar Gudino's NPI number?

The NPI number for Omar Gudino is 1699899674. It was assigned to this individual provider in the NPPES registry on March 16, 2007.

Q: What is Omar Gudino's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: Is Omar Gudino enrolled in Medicare?

No. Omar Gudino has opted out of Medicare through July 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.

Q: When was this NPI record last updated?

The NPPES record for Omar Gudino was last updated on November 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 16, 2007Opted out of Medicare · through Jul 1, 2027

2000 ALAMEDA DE LAS PULGAS STE 242, SAN MATEO, CA 94403(650) 931-6565 Get Directions Write a Review

NPPES record last updated: November 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 2, 2023, Aug 28, 2020, May 31, 2020 (3 updates tracked since 2020).

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About Dr. Omar Gabriel Gudino Ph.d., Abpp NPPES

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

DR. OMAR GABRIEL GUDINO PH.D., ABPP (NPI 1699899674) is an individual clinical child & adolescent provider in San Mateo, California, licensed in California (34415) and active in the NPI registry since March 2007. He has opted out of Medicare through July 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1699899674

Entity TypeIndividualMale

Primary Taxonomy103TC2200X

Provider Legal NameDR. OMAR GABRIEL GUDINOCredential: PH.D., ABPP

Location Address2000 ALAMEDA DE LAS PULGAS STE 242San Mateo, CA 94403-1271

Mailing Address2000 Alameda De Las Pulgas Ste 242San Mateo, CA 94403-1271 · (650) 931-6565

Phone(650) 931-6565

Sole ProprietorNo

Enumeration DateMarch 16, 2007

Last NPPES UpdateNovember 2, 20233 updates tracked since enumeration

NPPES CertifiedNovember 2, 2023

✔ NPI 1699899674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

Licenses✔ Licensed in CA · 34415✔ Licensed in NY · 018596

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X · License 34415 (CA), 018596 (NY)

2000 ALAMEDA DE LAS PULGAS STE 242, San Mateo, CA 94403

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Omar Gabriel Gudino Ph.d., Abpp 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 July 1, 2019 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2019

Opt-Out In Effect ThroughJuly 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 6

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

CHILD MIND MEDICAL PRACTICE, PC

Clinic/Center (Adolescent and Children Mental Health)