Active NPI
George Koumaras, PHD
- Psychologist
- San Marcos, CA
National Provider Identifier
1154377901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 277 Rancheros Dr Ste 301
San Marcos, CA 92069-2993 - Phone
- (760) 471-4073
- Fax
- (619) 528-4625
- NPI assigned
- May 25, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
277 Rancheros Dr Ste 301
San Marcos, CA 92069-2993
Mailing address
PO Box 609001
San Diego, CA 92160-9001
Phone (619) 528-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6178 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620259200000",
"number": "1154377901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 609001",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921609001",
"telephone_number": "619-528-4600",
"fax_number": "619-528-4625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "277 RANCHEROS DR STE 301",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920692993",
"telephone_number": "760-471-4073",
"fax_number": "619-528-4625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUMARAS",
"first_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2021-05-06",
"certification_date": "2021-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Marcos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.