Active NPI
Timothy Dane Durick, PSYD
- Clinical Psychologist
- Visalia, CA
National Provider Identifier
1114097003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY16229
- Practice address
- 5957 S Mooney Blvd
Visalia, CA 93277-9394 - Phone
- (559) 733-6880
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
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 | PSY16229 | CA | Primary |
Addresses
Primary practice location
5957 S Mooney Blvd
Visalia, CA 93277-9394
Mailing address
5957 S Mooney Blvd
Visalia, CA 93277-9394
Phone (559) 737-4669
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16229 | CA | MD | Clinical Psychologist |
| 16229 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1114097003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5957 S MOONEY BLVD",
"city": "VISALIA",
"state": "CA",
"postal_code": "932779394",
"telephone_number": "559-737-4669",
"fax_number": "559-737-4697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5957 S MOONEY BLVD",
"city": "VISALIA",
"state": "CA",
"postal_code": "932779394",
"telephone_number": "559-733-6880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURICK",
"first_name": "TIMOTHY",
"middle_name": "DANE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY16229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Visalia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.