Active NPI
Daniel R Gross, PSY.D.
- Psychologist
- Tempe, AZ
National Provider Identifier
1164701751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4523
- Practice address
- 1155 W Grove Pkwy
Apt. 329
Tempe, AZ 85283-4409 - Phone
- (800) 577-4701
- NPI assigned
- Aug 12, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4523 | AZ | Primary |
| Psychologist | 103T00000X | PY60495640 | WA |
Addresses
Primary practice location
1155 W Grove Pkwy
Apt. 329
Tempe, AZ 85283-4409
Mailing address
3843 S Bristol St
#459
Santa Ana, CA 92704-7426
Phone (800) 577-4701
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4523 | AZ | MD | Psychologist |
| PY60495640 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442534400000",
"number": "1164701751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3843 S BRISTOL ST",
"address_2": "#459",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927047426",
"telephone_number": "800-577-4701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 W GROVE PKWY",
"address_2": "APT. 329",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852834409",
"telephone_number": "800-577-4701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "DANIEL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-12",
"last_updated": "2015-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "4523",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY60495640",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.