Carlton W. Purviance, PH.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY4081 Issued in CA

Practice address

1416 Tennessee St
Suite 3a
Vallejo, CA 94590-4647

Phone

(707) 552-6397

Fax

(707) 647-1305

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316979818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 TENNESSEE ST",
            "address_2": "SUITE 3A",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904647",
            "telephone_number": "707-552-6397",
            "fax_number": "707-647-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 TENNESSEE ST",
            "address_2": "SUITE 3A",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904647",
            "telephone_number": "707-552-6397",
            "fax_number": "707-647-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURVIANCE",
        "first_name": "CARLTON",
        "middle_name": "W.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY4081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Forensic Psychologist in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.