Individual provider Active NPI

William Scott Gerwin, PH.D.

  • Psychologist
  • Kentfield, CA
National Provider Identifier
1144469941
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY18405 Issued in CA
Practice address
1036 Sir Francis Drake Blvd
Kentfield, CA 94904-1427
Phone
(415) 721-7290
Fax
(415) 721-7290
NPI assigned
Feb 18, 2009
Last updated
Feb 18, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY18405 CA Primary

Addresses

Primary practice location

1036 Sir Francis Drake Blvd
Kentfield, CA 94904-1427

Mailing address

PO Box 678
Corte Madera, CA 94976-0678
Phone (415) 721-7290

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY18405CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1144469941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949760678",
            "telephone_number": "415-721-7290",
            "fax_number": "415-721-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041427",
            "telephone_number": "415-721-7290",
            "fax_number": "415-721-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERWIN",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY18405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.