Individual provider Active NPI

Gerald L Schroeder, PH.D.

  • Clinical Psychologist
  • Santa Barbara, CA
National Provider Identifier
1659414985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4465 Issued in CA
Practice address
2323 De la Vina St
301
Santa Barbara, CA 93105-3877
Phone
(805) 682-1866
Fax
(805) 682-1866
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY4465 CA Primary

Addresses

Primary practice location

2323 De la Vina St
301
Santa Barbara, CA 93105-3877

Mailing address

2323 De la Vina St
301
Santa Barbara, CA 93105-3877
Phone (805) 682-1866

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY4465CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659414985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 DE LA VINA ST",
            "address_2": "301",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053877",
            "telephone_number": "805-682-1866",
            "fax_number": "805-682-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 DE LA VINA ST",
            "address_2": "301",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053877",
            "telephone_number": "805-682-1866",
            "fax_number": "805-682-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "GERALD",
        "middle_name": "L",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • 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.