Active NPI
Robert Davis Mosby, PH.D
- Clinical Psychologist
- Santa Rosa, CA
National Provider Identifier
1750670030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY23882
- Practice address
- 1160 N Dutton Ave Ste 230
Santa Rosa, CA 95401-4658 - Phone
- (707) 303-3201
- NPI assigned
- Apr 7, 2011
- Last updated
- Apr 7, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY23882 | CA | Primary |
| Group Psychotherapy Psychologist | 103TP2701X | PSY23882 | CA |
Addresses
Primary practice location
1160 N Dutton Ave Ste 230
Santa Rosa, CA 95401-4658
Mailing address
611 Alta Vista Dr
Healdsburg, CA 95448-4651
Phone (707) 431-2468
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1160 N Dutton Ave
Suite 230
Santa Rosa, CA 95401-4658
Phone (707) 303-3201
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY23882 | CA | MD | Group Psychotherapy Psychologist |
| 23882 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psych Strategies Inc a Psychological Corp | Current | Accepting new patients |
Locations
1160 N Dutton Ave
Ste 230
Santa Rosa, CA 95401
Phone (707) 303-3201
Organizations & group practices 1
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.
-
dba PsychStrategies
- Psychologist
- Santa Rosa, CA
- NPI 1699775411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1750670030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 ALTA VISTA DR",
"city": "HEALDSBURG",
"state": "CA",
"postal_code": "954484651",
"telephone_number": "707-431-2468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 N DUTTON AVE STE 230",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954014658",
"telephone_number": "707-303-3201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSBY",
"first_name": "ROBERT",
"middle_name": "DAVIS",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY23882",
"primary": true
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "CA",
"license": "PSY23882",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.