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I am in the office four days a week.  I do not see patients on Tuesdays.




My fees are based on a charge of $500/60 minutes.  Most initial visits are 60-90 minutes.  Most follow up appointments are 30-45 minutes. Fees are pro-rated based on the duration of the appointment.


Payment is due at the time of service unless other arrangements have been made. I accept VISA/Mastercard, checks or cash, or PayPal


I do not bill third party payors such as insurance companies or government programs (Medicare or MediCal). I will provide you with a statement that you may submit to your insurer for out of network reimbursement. Statements include all relevant information required for reimbursement including my tax ID number, ICD-10 diagnostic code and CPT procedure code.



I maintain confidential records and will not release information to anyone without patient or parent/guardian consent.  


I work with a web-based practice management program and prescribe medications electronically.  I have careful procedures in place to ensure the physical and digital safety of your personal health information.


When you come in for your initial appointment you will be asked to review and sign this:  Practice Policies (PDF). 

This document outlines Privacy Practices: Notice of Privacy Policies (PDF).


Missed Sessions 


I require 24 hours notice of cancellation or will bill the full fee for the missed appointment. I make exceptions only for serious medical emergencies. Missed initial evaluations will be rescheduled upon receipt of payment for both the missed appointment plus the evaluation fee.




I have opted out of the federal Medicare program. Individuals with Medicare coverage may work with me only if they sign a private contract (PDF) and may not submit my charges to Medicare for reimbursement. This contract must be signed prior to beginning treatment.

Below is a summary of this topic prepared by the American Psychiatric Association:


Essential Things to Know About Opting Out

Since January 1, 1998, physicians have been permitted to opt out of Medicare and enter into private contracts with Medicare beneficiaries that allow them to set their own fees. A physician who opts out of Medicare agrees not to see any Medicare patients (barring emergencies or urgent services), except for those with whom he has entered into private contracts, for a period of two years.

* Patients who reach Medicare age but are still employed and covered by their employers' insurance can choose not to enroll in Medicare Part B and will then not be Medicare beneficiaries for the purpose of their treatment by physicians.

* If a Medicare-eligible patient is covered under her employer’s insurance, but chooses to enroll in Medicare Part B so that Medicare will serve as the secondary payer, you must still have an opt out contract with this patient or you will be bound to the Medicare-allowed fees (even though Medicare is not the primary payer).

* When a Medicare beneficiary signs a private contract with one physician, it does not mean Medicare will not cover medical services provided to the same beneficiary by others who have not opted out. This means that if an opted out physician refers a patient to a lab to have blood work done, or to another specialist who has not opted out of Medicare, the services the patient receives as a result of the referral will be covered by Medicare (if they are services that Medicare ordinarily covers).


Prescription Refills


Prescriptions are renewed via It is best if your pharmacy contacts me directly -- via Allscripts or can fax a request for a refill to 415-924-8965. Please be mindful that medication refills are not instantly available and plan accordingly.



I try to return all calls and emails as promptly as possible. I am more likely to respond rapidly to emails.  If emails are more than a few sentences long I may have to charge for my time to review and respond.  Since all electronic communication has risks I ask that you review and sign this form:  Email Consent Form (PDF).

Non Medical Providers 


I work comfortably with non-medical providers and accept referrals for medication evaluation and management. Patients of course will only be treated if they consent to unrestricted collaboration with their therapist.

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