Active NPI
Samantha R Fordwood, PH.D.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1184850273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 22714
- Practice address
- 870 Market St
Suite 845
San Francisco, CA 94102-3099 - Phone
- (415) 963-3554
- Fax
- (415) 788-8000
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | PSY 22714 | CA | Primary |
Addresses
Primary practice location
870 Market St
Suite 845
San Francisco, CA 94102-3099
Mailing address
870 Market St
Suite 845
San Francisco, CA 94102-3099
Phone (415) 963-3554
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 22714 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of California San Francisco | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378425600000",
"number": "1184850273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 MARKET ST",
"address_2": "SUITE 845",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941023099",
"telephone_number": "415-963-3554",
"fax_number": "415-788-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 MARKET ST",
"address_2": "SUITE 845",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941023099",
"telephone_number": "415-963-3554",
"fax_number": "415-788-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORDWOOD",
"first_name": "SAMANTHA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-03",
"last_updated": "2013-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 22714",
"primary": true
}
],
"identifiers": [],
"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 Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.