Active NPI
David Michael Green, PH.D
- Forensic Psychologist
- San Diego, CA
National Provider Identifier
1457417685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- PSY4696
- Practice address
- 3549 Camino del Rio S
Suite D
San Diego, CA 92108-4023 - Phone
- (619) 281-0616
- Fax
- (619) 528-1263
- NPI assigned
- Dec 30, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY4696 | CA | |
| Forensic Psychologist | 103TF0200X | PSY4696 | CA | Primary |
Addresses
Primary practice location
3549 Camino del Rio S
Suite D
San Diego, CA 92108-4023
Mailing address
5333 Mission Center Rd
Suite 354
San Diego, CA 92108
Phone (619) 281-0616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| YYY49122Y | Medicaid | CA |
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 |
|---|---|---|---|
| PSY4696 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Green, PH.D. & Louise Green, PH.D., Apc | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- San Diego, CA
- NPI 1841441938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1457417685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5333 MISSION CENTER RD",
"address_2": "SUITE 354",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92108",
"telephone_number": "619-281-0616",
"fax_number": "619-528-1263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3549 CAMINO DEL RIO S",
"address_2": "SUITE D",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084023",
"telephone_number": "619-281-0616",
"fax_number": "619-528-1263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-30",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY4696",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "PSY4696",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "YYY49122Y",
"state": "CA"
}
],
"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 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.