Individual provider Active NPI

Dwayne Schanz, PSY.D

  • Clinical Child & Adolescent Psychologist
  • San Francisco, CA
National Provider Identifier
1104984129
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY22013 Issued in CA
Practice address
2482 Sutter St.
San Francisco, CA 94114
Phone
(415) 518-7640
Fax
(815) 717-7625
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X
Clinical Child & Adolescent Psychologist 103TC2200X PSY22013 CA Primary

Addresses

Primary practice location

2482 Sutter St.
San Francisco, CA 94114

Mailing address

2482 Sutter St.
San Francisco, CA 94114
Phone (415) 518-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY22013CAMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1104984129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2482 SUTTER ST.",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94114",
            "telephone_number": "415-518-7640",
            "fax_number": "815-717-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2482 SUTTER ST.",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94114",
            "telephone_number": "415-518-7640",
            "fax_number": "815-717-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHANZ",
        "first_name": "DWAYNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY22013",
            "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 Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.