Individual provider Active NPI

Todd Troutman, PSYD

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1104053537
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY24723 Issued in CA
Practice address
66 Mint St
1St Floor
San Francisco, CA 94103-1800
Phone
(415) 820-1625
NPI assigned
Jun 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY24723 CA Primary

Addresses

Primary practice location

66 Mint St
1St Floor
San Francisco, CA 94103-1800

Mailing address

66 Mint St
1St Floor
San Francisco, CA 94103-1800
Phone (415) 820-1625

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
I20140110001107 CA Practitioner - Clinical Psychologist 1153559596 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

450 Gough St
FL 2
San Francisco, CA 94102-4425
Phone (415) 820-1625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY24723CAMDClinical Psychologist
24723CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1104053537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 MINT ST",
            "address_2": "1ST FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031800",
            "telephone_number": "415-820-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 MINT ST",
            "address_2": "1ST FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031800",
            "telephone_number": "415-820-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUTMAN",
        "first_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.