Matthew Weisskopf, PSYCHOLOGIST

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY21048 Issued in CA

Practice address

2423 Camino del Rio S Ste 102
San Diego, CA 92108-3734

Phone

(858) 232-6136

Fax

(888) 753-7206

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

• Matthew Weisskopf, PH.D.,a Psychological Corporation

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1184062655
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1710055785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5339 OUTLOOK PT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241819",
            "telephone_number": "858-232-6136",
            "fax_number": "888-753-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083734",
            "telephone_number": "858-232-6136",
            "fax_number": "888-753-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSKOPF",
        "first_name": "MATTHEW",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "PSY21048",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marvin C. Weiss, MD
• Gary A Weissberg, MD
• Philip Alfred Weissbrod, M.D.
• Robert Weissenfels
• Claire Katherine Weisskopf, PA-C
• Tamar Judith Towne Weissler, MD
• Cory R Weissman, MD
• Jeffrey Weissman, M.D.
• Mitra Weissman, RD, CNSC, CDE
• Jeffrey Weistrop, PT

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.