NPIMap

Organization Active NPI

Gordon Psychotherapy, P.C.

  • Clinical Psychologist
  • Folsom, CA
National Provider Identifier
1255541074
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY6640 Issued in CA
Legal business name
GORDON PSYCHOTHERAPY, P.C.
Practice address
1568 Creekside Dr
Suite #206
Folsom, CA 95630-3449
Phone
(916) 984-9148
Fax
(916) 933-9068
NPI assigned
May 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David A Gordon, PH.DNPI 1205047842
Title
Owner - Vice- President
Phone
(916) 984-9148

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY6640 CA Primary

Addresses

Primary practice location

1568 Creekside Dr
Suite #206
Folsom, CA 95630-3449

Mailing address

1568 Creekside Dr
Suite #206
Folsom, CA 95630-3449
Phone (916) 984-9148

National Provider Directory

National Provider Directory

Locations

1568 Creekside Dr
Ste 206
Folsom, CA 95630
Phone (916) 404-4400

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255541074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 CREEKSIDE DR",
            "address_2": "SUITE #206",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303449",
            "telephone_number": "916-984-9148",
            "fax_number": "916-933-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 CREEKSIDE DR",
            "address_2": "SUITE #206",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303449",
            "telephone_number": "916-984-9148",
            "fax_number": "916-933-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON PSYCHOTHERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER - VICE- PRESIDENT",
        "authorized_official_telephone_number": "916-984-9148",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY6640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.