Active NPI
Garth A Copenhaver, PSY.D.
- Psychologist
- San Francisco, CA
National Provider Identifier
1255606059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY24808
- Practice address
- 295 A Fell Street
San Francisco, CA 94802 - Phone
- (415) 450-0843
- NPI assigned
- Mar 13, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY24808 | CA | Primary |
| Clinical Psychologist | 103TC0700X | PSY24808 | CA |
Addresses
Primary practice location
295 A Fell Street
San Francisco, CA 94802
Mailing address
295 A Fell Street
San Francisco, CA 94802
Phone (415) 450-0843
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY24808 | CA | MD | Psychologist |
| 24808 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331596800000",
"number": "1255606059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 A FELL STREET",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94802",
"telephone_number": "415-450-0843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 A FELL STREET",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94802",
"telephone_number": "415-450-0843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPENHAVER",
"first_name": "GARTH",
"middle_name": "A",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-13",
"last_updated": "2012-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY24808",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY24808",
"primary": false
}
],
"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 Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.