Active NPI
Robert Gregory Nunn, PH.D., BCBA-D
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1386925204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY6881
- Practice address
- 11225 Woodrush LN
San Diego, CA 92128-3605 - Phone
- (858) 675-0065
- Fax
- (858) 675-0065
- NPI assigned
- Sep 6, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | PSY6881 | CA | |
| Clinical Psychologist | 103TC0700X | PSY6881 | CA | Primary |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | PSY6881 | CA | |
| School Psychologist | 103TS0200X | PSY6881 | CA |
Addresses
Primary practice location
11225 Woodrush LN
San Diego, CA 92128-3605
Mailing address
11225 Woodrush LN
San Diego, CA 92128-3605
Phone (858) 675-0065
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY6881 | CA | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1386925204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11225 WOODRUSH LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283605",
"telephone_number": "858-675-0065",
"fax_number": "858-675-0065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11225 WOODRUSH LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283605",
"telephone_number": "858-675-0065",
"fax_number": "858-675-0065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUNN",
"first_name": "ROBERT",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "PH.D., BCBA-D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-06",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "PSY6881",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY6881",
"primary": true
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "CA",
"license": "PSY6881",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "PSY6881",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.