Individual provider Active NPI

G. Preston Sims, PH.D.

  • Psychologist
  • Solana Beach, CA
National Provider Identifier
1053547711
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY12830 Issued in CA
Practice address
674 Via de la Valle
Ste. 216
Solana Beach, CA 92075-3407
Phone
(619) 607-2672
Fax
(858) 509-1214
NPI assigned
Jun 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY12830 CA Primary
Clinical Psychologist 103TC0700X PSY12830 CA
Forensic Psychologist 103TF0200X PSY12830 CA

Addresses

Primary practice location

674 Via de la Valle
Ste. 216
Solana Beach, CA 92075-3407

Mailing address

674 Via de la Valle
Ste. 216
Solana Beach, CA 92075-3407
Phone (619) 607-2672

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
I20200321000364 CA Practitioner - Clinical Psychologist 7719315969 Practice locations: Solana Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

265 Santa Helena
Suite 214
Solana Beach, CA 92075-1546
Phone (619) 607-2672

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1053547711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 VIA DE LA VALLE",
            "address_2": "STE. 216",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920753407",
            "telephone_number": "619-607-2672",
            "fax_number": "858-509-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 VIA DE LA VALLE",
            "address_2": "STE. 216",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920753407",
            "telephone_number": "619-607-2672",
            "fax_number": "858-509-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "G.",
        "middle_name": "PRESTON",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12830",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12830",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY12830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solana Beach, CA

Sources for this page

Verify at the official NPI Registry.