Active NPI
Melinda Douglass, PSYD
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1669719100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 24855
- Practice address
- 220 Montgomery St
Suite 400
San Francisco, CA 94104-3402 - Phone
- (415) 215-4796
- Fax
- (415) 800-8480
- NPI assigned
- Jan 3, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 24855 | CA | Primary |
Addresses
Primary practice location
220 Montgomery St
Suite 400
San Francisco, CA 94104-3402
Mailing address
1801 Bush St
Suite 110
San Francisco, CA 94109-5239
Phone (415) 215-4796
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24855 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1669719100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 BUSH ST",
"address_2": "SUITE 110",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941095239",
"telephone_number": "415-215-4796",
"fax_number": "415-800-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 MONTGOMERY ST",
"address_2": "SUITE 400",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941043402",
"telephone_number": "415-215-4796",
"fax_number": "415-800-8480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "MELINDA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-03",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "24855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.