Mitchel Gregg Adler, PSY.D.

Key facts

NPI

1003062225

Entity type

Individual (NPI type 1)

Primary specialty

Psychologist 103T00000X

License

PSY19167 (CA)

Practice address

433 F St
Davis, CA 95616-4111

Phone

(530) 219-5985

NPI assigned

Aug 8, 2008

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 27, 2025 through Jun 27, 2027

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 8, 2008.

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1003062225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 F ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 F ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164111",
            "telephone_number": "530-219-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADLER",
        "first_name": "MITCHEL",
        "middle_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-08",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Davis, CA · Psychologist in California