James Alton Reavis Jr., PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY17404 Issued in CA

Practice address

964 Fifth Ave
#200
San Diego, CA 92101-6102

Phone

(619) 234-7970

Fax

(619) 699-5945

NPI assigned

Aug 31, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• James a. Reavis, Psy.D. a Psychological Corporation

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1437398468
  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619089406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 FIFTH AVE",
            "address_2": "#200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016102",
            "telephone_number": "619-234-7970",
            "fax_number": "619-699-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 FIFTH AVE",
            "address_2": "#200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016102",
            "telephone_number": "619-234-7970",
            "fax_number": "619-699-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVIS",
        "first_name": "JAMES",
        "middle_name": "ALTON",
        "name_suffix": "Jr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY17404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry Reasbeck
• Richard Reason
• Vitou Reat
• Elika NE'Sheal Reaux
• Douglas William Reavie, M.D.
• Karen Reavis, N.P.
• Reaware Licensed Clinical Social Work Prof Corp
• Reaware Outreach, Inc.
• Rebecca a. Marsh, DDS, Apc
• Rebecca Quinn Licensed Marriage and Family Therapist Inc

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.