Active NPI
George Joseph Grosso, PHD PSYCH
- Forensic Psychologist
- Tehachapi, CA
National Provider Identifier
1811198906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- PSY10108
- Practice address
- 24100 Sorrel Court
Tehachapi, CA 93561 - Phone
- (661) 822-9011
- Fax
- (661) 822-0476
- NPI assigned
- May 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY10108 | CA | |
| Clinical Psychologist | 103TC0700X | PSY10108 | CA | |
| Prescribing (Medical) Psychologist | 103TP0016X | |||
| Forensic Psychologist | 103TF0200X | PSY10108 | CA | Primary |
Addresses
Primary practice location
24100 Sorrel Court
Tehachapi, CA 93561
Mailing address
24100 Sorrel Court
Tehachapi, CA 93561
Phone (661) 822-9011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY10108 | CA | MD | Clinical Psychologist |
| 10108 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1811198906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24100 SORREL COURT",
"city": "TEHACHAPI",
"state": "CA",
"postal_code": "93561",
"telephone_number": "661-822-9011",
"fax_number": "661-822-0476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24100 SORREL COURT",
"city": "TEHACHAPI",
"state": "CA",
"postal_code": "93561",
"telephone_number": "661-822-9011",
"fax_number": "661-822-0476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSO",
"first_name": "GEORGE",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHD PSYCH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-29",
"last_updated": "2023-03-14",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY10108",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY10108",
"primary": false
},
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "PSY10108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tehachapi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.