Active NPI
Andrew Davis, PH.D.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1396020327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY28545
- Practice address
- 673 San Jose Ave
San Francisco, CA 94110-4914 - Phone
- (415) 282-3789
- NPI assigned
- Oct 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | PSY28545 | CA | Primary |
Addresses
Primary practice location
673 San Jose Ave
San Francisco, CA 94110-4914
Mailing address
1499 Huntington Dr
South Pasadena, CA 91030-4552
Phone (213) 948-3172
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 |
|---|---|---|---|
| PSY28545 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baker Place, Inc | Past | Accepting new patients | |
| Baker Places, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Addiction (Substance Use Disorder) Counselor
- San Francisco, CA
- NPI 1891107116
-
dba San Jose Place
- Community/Behavioral Health Agency
- San Francisco, CA
- NPI 1720125925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1396020327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 HUNTINGTON DR",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910304552",
"telephone_number": "213-948-3172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "673 SAN JOSE AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941104914",
"telephone_number": "415-282-3789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANDREW",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-21",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY28545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.