Active NPI
Samuel Gerson, PH.D.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1073024832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY8786
- Practice address
- 2252 Fillmore St
San Francisco, CA 94115-2299 - Phone
- (510) 654-4525
- NPI assigned
- Oct 19, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY8786 | CA | Primary |
Addresses
Primary practice location
2252 Fillmore St
San Francisco, CA 94115-2299
Mailing address
2252 Fillmore St
San Francisco, CA 94115-2299
Phone (510) 654-4525
Other practice location 1
5625 College Ave Ste 213
Oakland, CA 94618-1585
Phone (510) 654-4525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 27, 2021 through Oct 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8786 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1073024832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2252 FILLMORE ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152299",
"telephone_number": "510-654-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2252 FILLMORE ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152299",
"telephone_number": "510-654-4525"
}
],
"practiceLocations": [
{
"address_1": "5625 College Ave Ste 213",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946181585",
"country_code": "US",
"telephone_number": "510-654-4525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GERSON",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY8786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.