Joseph Patrick Gannon, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

PSY12034 Issued in CA

Practice address

4445 Eastgate Mall Ste 200
San Diego, CA 92121-1979

Phone

(858) 705-5439

Fax

(858) 771-1078

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1467440347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "858-705-5439",
            "fax_number": "858-771-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "858-705-5439",
            "fax_number": "858-771-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "JOSEPH",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY12034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD/BLUE CROSS",
            "identifier": "OPL120340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lyle Gangsei, PHD
• Theodore G Ganiats, M.D.
• Andrea Ganier
• Rose Elaine Ganley
• Addison Newkirk Gann
• Nicholas Edward Gannon, DO
• Seth Michael Gans, LMFT
• Ashley Marie Gant
• Srujan Ganta, MD
• Allan Nelson Ganuza, IDC

• Cognitive & Behavioral Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.