Active NPI
Philippe Gendrault, PH.D.
- Psychologist
- San Francisco, CA
National Provider Identifier
1205120367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 19040
- Practice address
- 3702 Sacramento St
San Francisco, CA 94118-1740 - Phone
- (415) 289-7033
- NPI assigned
- Jun 7, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 19040 | CA | Primary |
Addresses
Primary practice location
3702 Sacramento St
San Francisco, CA 94118-1740
Mailing address
3702 Sacramento St
San Francisco, CA 94118-1740
Phone (415) 289-7033
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19040 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1205120367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3702 SACRAMENTO ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941181740",
"telephone_number": "415-289-7033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3702 SACRAMENTO ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941181740",
"telephone_number": "415-289-7033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENDRAULT",
"first_name": "PHILIPPE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-07",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "19040",
"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 Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.