Active NPI
George Henry Graham III, PH.D.
- Cognitive & Behavioral Psychologist
- San Diego, CA
National Provider Identifier
1811248255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- PSY18665
- Practice address
- 9310 Pipilo St
San Diego, CA 92129-3576 - Phone
- (858) 538-2650
- NPI assigned
- Sep 25, 2012
- 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 |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY18665 | CA | Primary |
Addresses
Primary practice location
9310 Pipilo St
San Diego, CA 92129-3576
Mailing address
9310 Pipilo St
San Diego, CA 92129-3576
Phone (858) 538-2650
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18665 | CA | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1811248255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9310 PIPILO ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921293576",
"telephone_number": "858-538-2650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9310 PIPILO ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921293576",
"telephone_number": "858-538-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "GEORGE",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-25",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "PSY18665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.