Individual provider Active NPI

J. Michael Priddy, PHD

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1144283466
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10186 Issued in CA
Practice address
1801 Bush St
Suite 111
San Francisco, CA 94109-5239
Phone
(415) 752-2726
NPI assigned
Apr 8, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 PSY10186 CA Primary

Addresses

Primary practice location

1801 Bush St
Suite 111
San Francisco, CA 94109-5239

Mailing address

1 Baywood Ave
Suite 7
San Mateo, CA 94402-1523
Phone (701) 255-9279

Other identifiers 1

IdentifierTypeStateIssuer
PSY10186OtherCASTATE LICENSE

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY10186CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1144283466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYWOOD AVE",
            "address_2": "SUITE 7",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021523",
            "telephone_number": "701-255-9279",
            "fax_number": "701-222-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 BUSH ST",
            "address_2": "SUITE 111",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095239",
            "telephone_number": "415-752-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDDY",
        "first_name": "J. MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY10186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PSY10186",
            "state": "CA"
        }
    ],
    "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 Jul 13, 2026; 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.