Daniel R Model, PSY

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 19315 Issued in CA

Practice address

1080 Emeline Ave
Santa Cruz, CA 95060-1966

Phone

(831) 454-4100

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Santa Cruz

  • Clinic/Center
  • Santa Cruz, CA
  • NPI 1659315430
  Medicare reassignment NPD
• County of Santa Cruz

  • Federally Qualified Health Center (FQHC)
  • Watsonville, CA
  • NPI 1770709149
  Medicare reassignment NPD
• County of Santa Cruz

  • Federally Qualified Health Center (FQHC)
  • Santa Cruz, CA
  • NPI 1285033514
  NPD
• County of Santa Cruz

  • Federally Qualified Health Center (FQHC)
  • Santa Cruz, CA
  • NPI 1578680310
  NPD
• Puentes Al Sur

  • Adult Mental Health Clinic/Center
  • Watsonville, CA
  • NPI 1992849012
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1316960958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4100",
            "fax_number": "831-454-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODEL",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "PSY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 19315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PSY 19315",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Solomon Quinn Mitchell, D.C.
• Tobin Mitchell
• Surindra N Mitruka, MD
• Hannah Elisabeth Mixter, DMD
• John Mizelle, LMFT
• Modesto Radiological Medical Group, Inc
• Catherine Pauline Modjeski, D.D.S
• Sapan Mody, MD
• Laura Moe, OTR
• Anny Leidy Mogollon

• Clinical Psychologist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.