Individual provider Active NPI

David Ross Atkinson, PHD

  • Clinical Neuropsychologist
  • San Luis Obispo, CA
National Provider Identifier
1417086554
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY6801 Issued in CA
Practice address
1428 Phillips LN
Suite 300
San Luis Obispo, CA 93401-2537
Phone
(805) 545-5720
Fax
(805) 545-5727
NPI assigned
Mar 5, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY6801 CA Primary
Clinical Psychologist 103TC0700X PSY6801 CA

Addresses

Primary practice location

1428 Phillips LN
Suite 300
San Luis Obispo, CA 93401-2537

Mailing address

377 Albert Dr
San Luis Obispo, CA 93405-1926
Phone (805) 545-0750

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

LicenseStateTypeSpecialty
PSY6801CAMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417086554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 ALBERT DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051926",
            "telephone_number": "805-545-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 PHILLIPS LN",
            "address_2": "SUITE 300",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012537",
            "telephone_number": "805-545-5720",
            "fax_number": "805-545-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "DAVID",
        "middle_name": "ROSS",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY6801",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY6801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.