Active NPI
George Daniel Venable, PH.D.
- Clinical Psychologist
- La Mesa, CA
National Provider Identifier
1245429752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 9362
- Practice address
- 8029 La Mesa Blvd
La Mesa, CA 91941-6434 - Phone
- (800) 424-2686
- Fax
- (619) 466-2662
- NPI assigned
- Oct 20, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 9362 | CA | Primary |
Addresses
Primary practice location
8029 La Mesa Blvd
La Mesa, CA 91941-6434
Mailing address
2142 Hanover PL
Rocklin, CA 95765-6106
Phone (916) 225-2615
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 9362 | CA | MD | Clinical Psychologist |
| 9362 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1245429752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2142 HANOVER PL",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957656106",
"telephone_number": "916-225-2615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8029 LA MESA BLVD",
"city": "LA MESA",
"state": "CA",
"postal_code": "919416434",
"telephone_number": "800-424-2686",
"fax_number": "619-466-2662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENABLE",
"first_name": "GEORGE",
"middle_name": "DANIEL",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-20",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 9362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.