Individual provider Active NPI

Jonathan Porteus, PHD

  • Group Psychotherapy Psychologist
  • Sacramento, CA
National Provider Identifier
1558400796
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
PSY19635 Issued in CA
Practice address
8912 Volunteer LN Ste 100
Sacramento, CA 95826-3224
Phone
(916) 368-3080
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

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 10

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY19635 CA
Counseling Psychologist 103TC1900X 14792 NY
Clinical Psychologist 103TC0700X 14792 NY
Clinical Psychologist 103TC0700X PSY19635 CA
Addiction (Substance Use Disorder) Psychologist 103TA0400X 14792 NY
Addiction (Substance Use Disorder) Psychologist 103TA0400X PSY19635 CA
Psychologist 103T00000X 14792 NY
Psychologist 103T00000X PSY19635 CA
Group Psychotherapy Psychologist 103TP2701X 14792 NY
Group Psychotherapy Psychologist 103TP2701X PSY19635 CA Primary

Addresses

Primary practice location

8912 Volunteer LN Ste 100
Sacramento, CA 95826-3224

Mailing address

3104 O St # 336
Sacramento, CA 95816-6519
Phone (916) 743-3022

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY19635CAMDCounseling Psychologist
14792NYMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1558400796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 O ST # 336",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166519",
            "telephone_number": "916-743-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8912 VOLUNTEER LN STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263224",
            "telephone_number": "916-368-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTEUS",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY19635",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "14792",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "14792",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19635",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "14792",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY19635",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "14792",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19635",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "14792",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY19635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, 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.