Individual provider Active NPI

Sharareh Gandy, PH.D.

  • Clinical Psychologist
  • Escondido, CA
National Provider Identifier
1730310723
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
28097 Issued in CA
Practice address
1121 E Washington Ave
Escondido, CA 92025-2214
Phone
(760) 871-0606
NPI assigned
Aug 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 28097 CA Primary

Addresses

Primary practice location

1121 E Washington Ave
Escondido, CA 92025-2214

Mailing address

1121 E Washington Ave
Escondido, CA 92025-2214

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170921001548 CA Practitioner - Clinical Psychologist 3779857222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Dap Health, Inc. CurrentSince Jul 6, 2024 Accepting new patients
Dap Health, Inc. CurrentSince Jul 6, 2024 Accepting new patients
Dap Health Inc. Current Accepting new patients

Locations

133 W Main St
El Cajon, CA 92020
Phone (619) 401-0404

1121 E Washington Ave
Escondido, CA 92025
Phone (760) 871-0606

1695 N Sunrise Way
Palm Springs, CA 92262
Phone (760) 325-9370

Interoperability endpoints

  • Direct secure messaging: sgandy684668@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1730310723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E WASHINGTON AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920252214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E WASHINGTON AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920252214",
            "telephone_number": "760-871-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDY",
        "first_name": "SHARAREH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "28097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.