Individual provider Active NPI

Gurveer Dosanjh, PSYD

  • Clinical Psychologist
  • Stockton, CA
National Provider Identifier
1457736514
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
34579 Issued in CA
Practice address
3620 W Hammer LN
Stockton, CA 95219-5532
Phone
(866) 523-4268
NPI assigned
Jul 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Psychologist 103TC0700X 34579 CA Primary

Addresses

Primary practice location

3620 W Hammer LN
Stockton, CA 95219-5532

Mailing address

1960 Veronica CT
Yuba City, CA 95993-7670
Phone (530) 844-3936

Other practice location 1

1855 2nd St Ste B
Concord, CA 94519-2623
Phone (855) 223-7123

Other practice location 2

251 Georgia St
Vallejo, CA 94590-5905
Phone (925) 265-6055

Other practice location 3

16465 Sierra Lakes Pkwy Ste 140
Fontana, CA 92336-1260
Phone (909) 244-9593

Other practice location 4

7807 Laguna Blvd Ste 400
Elk Grove, CA 95758-7953
Phone (909) 244-9593

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

State licenses

LicenseStateTypeSpecialty
34579CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowered Minds Clinical Current Accepting new patients
Anthony Benigno, PSYD., Psychological Services, PC PastSince Mar 12, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1457736514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 VERONICA CT",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959937670",
            "telephone_number": "530-844-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952195532",
            "telephone_number": "866-523-4268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 2nd St Ste B",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945192623",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 Georgia St",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945905905",
            "country_code": "US",
            "telephone_number": "925-265-6055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16465 Sierra Lakes Pkwy Ste 140",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923361260",
            "country_code": "US",
            "telephone_number": "909-244-9593",
            "fax_number": "833-903-0337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7807 Laguna Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957587953",
            "country_code": "US",
            "telephone_number": "909-244-9593",
            "fax_number": "833-903-0337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOSANJH",
        "first_name": "GURVEER",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "34579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.