Individual provider Active NPI

Jonathan H Rousell, PSY.D.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1679005912
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY29046 Issued in CA
Practice address
870 Market St
Suite 855
San Francisco, CA 94102-3099
Phone
(510) 545-3928
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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 PSY29046 CA Primary

Addresses

Primary practice location

870 Market St
Suite 855
San Francisco, CA 94102-3099

Mailing address

870 Market St
Suite 855
San Francisco, CA 94102-3099
Phone (510) 545-3928

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

LicenseStateTypeSpecialty
PSY29046CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1679005912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 MARKET ST",
            "address_2": "SUITE 855",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023099",
            "telephone_number": "510-545-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MARKET ST",
            "address_2": "SUITE 855",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023099",
            "telephone_number": "510-545-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSELL",
        "first_name": "JONATHAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29046",
            "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 Mar 28, 2017; 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.