Individual provider Active NPI

Andrew Jeremiah Levine, PH.D.

  • Clinical Neuropsychologist
  • Arcata, CA
National Provider Identifier
1003807876
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY20320 Issued in CA
Practice address
592 14TH St
Arcata, CA 95521-5808
Phone
(707) 595-7997
Fax
(510) 280-2993
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY20320 CA
Clinical Neuropsychologist 103G00000X PSY20320 CA Primary

Addresses

Primary practice location

592 14TH St
Arcata, CA 95521-5808

Mailing address

592 14TH St
Arcata, CA 95521-5808
Phone (707) 595-7997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170920000450 CA Practitioner - Clinical Psychologist 9436423175 Practice locations: Arcata, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

801 Crescent Way
Suite 3
Arcata, CA 95521-6781
Phone (562) 477-5963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY20320CAMDPsychologist
20320CAMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1003807876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 14TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215808",
            "telephone_number": "707-595-7997",
            "fax_number": "510-280-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 14TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215808",
            "telephone_number": "707-595-7997",
            "fax_number": "510-280-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "ANDREW",
        "middle_name": "JEREMIAH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY20320",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY20320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcata, CA

Sources for this page

Verify at the official NPI Registry.