Active NPI
Jonathan D Canick, PHD
- Clinical Neuropsychologist
- San Francisco, CA
National Provider Identifier
1720162944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY11376
- Practice address
- 2100 Webster St
Suite 320
San Francisco, CA 94115-2377 - Phone
- (415) 600-1491
- Fax
- (415) 474-9423
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- 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 Neuropsychologist | 103G00000X | PSY11376 | CA | Primary |
Addresses
Primary practice location
2100 Webster St
Suite 320
San Francisco, CA 94115-2377
Mailing address
2100 Webster Street
Suite 320
San Francisco, CA 94115-2377
Phone (415) 600-1491
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11376 | CA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207612800000",
"number": "1720162944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 WEBSTER STREET",
"address_2": "SUITE 320",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152377",
"telephone_number": "415-600-1491",
"fax_number": "415-474-9423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 WEBSTER ST",
"address_2": "SUITE 320",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152377",
"telephone_number": "415-600-1491",
"fax_number": "415-474-9423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANICK",
"first_name": "JONATHAN",
"middle_name": "D",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2008-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY11376",
"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 Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.