Active NPI
David John Reikowski, PHD
- Cognitive & Behavioral Psychologist
- Hollister, CA
National Provider Identifier
1396807483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- PSY15423
- Practice address
- 200 Tres Pinos Rd
Suite 103
Hollister, CA 95023-5544 - Phone
- (831) 636-1884
- Fax
- (831) 636-1884
- NPI assigned
- Dec 14, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY15423 | CA | Primary |
Addresses
Primary practice location
200 Tres Pinos Rd
Suite 103
Hollister, CA 95023-5544
Mailing address
200 Tres Pinos Rd
Suite 103
Hollister, CA 95023-5544
Phone (831) 636-1884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041005001264 | CA | Practitioner - Clinical Psychologist | 2860451820 | Practice locations: Hollister, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
200 Tres Pinos Rd
Suite 103
Hollister, CA 95023-5605
Phone (831) 636-1884
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15423 | CA | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538092800000",
"number": "1396807483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 TRES PINOS RD",
"address_2": "SUITE 103",
"city": "HOLLISTER",
"state": "CA",
"postal_code": "950235544",
"telephone_number": "831-636-1884",
"fax_number": "831-636-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TRES PINOS RD",
"address_2": "SUITE 103",
"city": "HOLLISTER",
"state": "CA",
"postal_code": "950235544",
"telephone_number": "831-636-1884",
"fax_number": "831-636-1884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIKOWSKI",
"first_name": "DAVID",
"middle_name": "JOHN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2018-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "PSY15423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollister, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.