Raymond David Sullivan, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSB94027027018 Issued in CA

Practice address

5276 Hollister Ave Ste 205
Santa Barbara, CA 93111-3066

Phone

(805) 392-8057

NPI assigned

Oct 19, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Ray Sullivan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1609658962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5591",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931505591",
            "telephone_number": "805-689-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5276 HOLLISTER AVE STE 205",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931113066",
            "telephone_number": "805-392-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "RAYMOND",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94027027018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAY",
            "last_name": "SULLIVAN",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wonsuk Warren Suh, M.D., M.P.H.
• Lee Sulka, P.T.
• Brian Ray Sullivan, PA-C
• Kelli Ann Sullivan, MFT
• Neil Patrick Sullivan, MD
• Liliane Samy Daoud Sultan
• Summit Ventures of Santa Barbara, LP (Summit Surgery Center)
• Robert Francis Sumner, LVN
• Justin Bengt Sundgot-Smith
• Louie April Jimenez Sundiam

• Clinical Psychologist in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.