Steven Douglas McCormick, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY12990 Issued in CA

Practice address

2288 Auburn Blvd.
Suite #101
Sacramento, CA 95821

Phone

(916) 640-8161

Fax

(916) 640-8151

NPI assigned

Mar 12, 2007

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

Other identifiers 1

Other names 1

• Mr. Steven Douglas McCormick Professional name

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1356473623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX #2306",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "95609",
            "telephone_number": "916-640-8161",
            "fax_number": "916-640-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 AUBURN BLVD.",
            "address_2": "SUITE #101",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95821",
            "telephone_number": "916-640-8161",
            "fax_number": "916-640-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "STEVEN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY12990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "171397200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEVEN",
            "last_name": "MCCORMICK",
            "middle_name": "DOUGLAS",
            "prefix": "MR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jenny McCormack, FNP-C
• Ronald McCormack, LCSW
• Zachary McCormack
• Colleen Ann McCormick
• Jenny Kristin McCormick, MD
• Willie McCormick
• Erin Lafler McCorry, M.D.
• Leslie Warren McCovey
• Amarah McCowan
• Kaylee Renee McCoy-Barba

• Clinical Neuropsychologist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.