Individual provider Active NPI

Amanda Gregory, PH.D.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1295971984
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 20207 Issued in CA
Practice address
3644 Market St
San Francisco, CA 94131-1339
Phone
(415) 796-2801
Fax
(415) 796-3309
NPI assigned
Dec 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY 20207 CA
Clinical Psychologist 103TC0700X PSY 20207 CA Primary

Addresses

Primary practice location

3644 Market St
San Francisco, CA 94131-1339

Mailing address

3644 Market St
San Francisco, CA 94131-1339
Phone (415) 796-2801

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

LicenseStateTypeSpecialty
PSY 20207CAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Medical Center 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.

NPI Registry JSON

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230595200000",
    "number": "1295971984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3644 MARKET ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941311339",
            "telephone_number": "415-796-2801",
            "fax_number": "415-796-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3644 MARKET ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941311339",
            "telephone_number": "415-796-2801",
            "fax_number": "415-796-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "AMANDA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-30",
        "last_updated": "2008-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 20207",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20207",
            "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 Dec 30, 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.

Verify at the official NPI Registry.