Scripps Psychiatric Medical Group

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G28587 Issued in CA

Legal business name

SCRIPPS PSYCHIATRIC MEDICAL GROUP

Practice address

4077 Fifth Ave
Scripps Mercy Hospital
San Diego, CA 92103-2105

Phone

(619) 359-6600

Fax

(619) 632-5736

NPI assigned

Apr 26, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Laurance Davis Cracroft, M.D.

Title

President

Phone

(619) 359-6600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1477908507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST STE 841",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032232",
            "telephone_number": "619-359-6600",
            "fax_number": "619-632-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 FIFTH AVE",
            "address_2": "SCRIPPS MERCY HOSPITAL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-359-6600",
            "fax_number": "619-632-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRIPPS PSYCHIATRIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "CRACROFT",
        "authorized_official_first_name": "LAURANCE",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-359-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G28587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scripps Health Services, LLC
• Scripps Mercy Ambulatory Surgery Center, LP
• Scripps Mercy Physicians Cardiology Medical Corporation
• Scripps Optometric Group
• Scripps Oral Pathology Service, LLC
• Scripps Ranch Dental
• Scripps Ranch Family Dentistry
• Scripps Ranch Family Dentistry
• Scripps Ranch Medical Clinic
• Brittany Scrivens, LMFT

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.