Individual provider Active NPI

Jeff Schanowitz, PH.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1679683007
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20362 Issued in CA
Practice address
5252 Balboa Ave
Suite 503
San Diego, CA 92117
Phone
(619) 252-3713
Fax
(619) 810-0620
NPI assigned
Aug 30, 2006
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY20362 CA
Psychologist 103T00000X 20362 CA Primary

Addresses

Primary practice location

5252 Balboa Ave
Suite 503
San Diego, CA 92117

Mailing address

13500 Ginger Glen Rd
San Diego, CA 92130
Phone (619) 252-3713

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY20362CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeff Schanowitz PHD Inc Current Accepting new patients
Jeff Schanowitz, PH.D. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1679683007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 GINGER GLEN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "619-252-3713",
            "fax_number": "858-536-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE",
            "address_2": "SUITE 503",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "619-252-3713",
            "fax_number": "619-810-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHANOWITZ",
        "first_name": "JEFF",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY20362",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "20362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.