Gerard Anthony Chambers Jr., PSY D, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

23778 Issued in CA

Practice address

2140 41St Ave
Ste 200B
Capitola, CA 95010-2067

Phone

(321) 208-1554

NPI assigned

Nov 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1679753156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 DOLPHIN DR",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950035711",
            "telephone_number": "321-208-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 41ST AVE",
            "address_2": "STE 200B",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102067",
            "telephone_number": "321-208-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "GERARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSY D, PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-13",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8816",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "23778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Capitola, CA
• Providers in Capitola, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.