Eric Van Der Voort Psychology PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ERIC VAN DER VOORT PSYCHOLOGY PC

Practice address

1050 University Ave Ste E107-77
San Diego, CA 92103-3359

Phone

(619) 786-8685

NPI assigned

Oct 1, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Eric William Van Der Voort, PSY.D.NPI 1366926495

Title

Owner / Clinical Psychologist

Phone

(619) 786-8685

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric William Van Der Voort, PSYD

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1366926495
  Authorized official Same address or phone

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1376184465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 UNIVERSITY AVE STE E107-77",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033359",
            "telephone_number": "619-786-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 UNIVERSITY AVE STE E107-77",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033359",
            "telephone_number": "619-786-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC VAN DER VOORT PSYCHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "VAN DER VOORT",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER / CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "619-786-8685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in San Diego, CA
• Providers in San Diego, 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 28, 2022; 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.