Individual provider Active NPI

Theodore Luke Germanos, M.D.

  • Child & Adolescent Psychiatry Physician
  • Solana Beach, CA
National Provider Identifier
1780046813
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A174881 Issued in CA
Practice address
462 Stevens Ave
Solana Beach, CA 92075-2075
Phone
(858) 365-8564
NPI assigned
Mar 28, 2016
Last updated
Aug 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A174881 CA
Child & Adolescent Psychiatry Physician 2084P0804X A174881 CA Primary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X A174881 CA

Addresses

Primary practice location

462 Stevens Ave
Solana Beach, CA 92075-2075

Mailing address

462 Stevens Ave
Solana Beach, CA 92075-2075

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A174881CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bold Health Medical Group, a Professional Corporation CurrentSince Aug 20, 2023 Accepting new patients
Saikaya Tree LLC Child & Adolescent Psychiatry Current Accepting new patients
TBT Psychiatry, Inc Child & Adolescent Psychiatry Current Accepting new patients

Locations

561 Saxony Pl
Ste 101
Encinitas, CA 92024
Phone (760) 503-4703

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1780046813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 STEVENS AVE",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 STEVENS AVE",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752075",
            "telephone_number": "858-365-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERMANOS",
        "first_name": "THEODORE",
        "middle_name": "LUKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A174881",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A174881",
            "primary": true
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A174881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solana Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.