Richard Giovannoli, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22314 Issued in CA

Practice address

874 Gravenstein Highway South
Suite 12
Sebastopol, CA 95472-5603

Phone

(707) 824-8834

Fax

(707) 922-0294

NPI assigned

Apr 10, 2007

Last updated

Oct 6, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1013130806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 GRAVENSTEIN HIGHWAY SOUTH",
            "address_2": "SUITE 12",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954725603",
            "telephone_number": "707-824-8834",
            "fax_number": "707-922-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 GRAVENSTEIN HIGHWAY SOUTH",
            "address_2": "SUITE 12",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954725603",
            "telephone_number": "707-824-8834",
            "fax_number": "707-922-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIOVANNOLI",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22314",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY22314",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa Carey Gardner
• Deborah Gail Garner-Hale, M. ED.
• Elaine Sohier Gayler, M.A.
• Danielle Ghilotti
• Anne Brown Gibson, MFT
• Julia Glanz, L.C.S.W.
• Merle Jenaii Gold, PH.D., MFT
• Mandi Goldberg
• Lia Golden-Byrd
• Jill A Goldreyer

• Clinical Psychologist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.