Active NPI
Donald W. Grimm, CP
- Clinical Psychologist
- Palm Springs, CA
National Provider Identifier
1861501405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY-20305
- Practice address
- 490 S Farrell Dr
Ste C207
Palm Springs, CA 92262-7944 - Phone
- (760) 699-6363
- Fax
- (951) 769-6753
- NPI assigned
- Aug 29, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY-20305 | CA | Primary |
Addresses
Primary practice location
490 S Farrell Dr
Ste C207
Palm Springs, CA 92262-7944
Mailing address
773 Pine Ridge Cir
Beaumont, CA 92223-7153
Phone (951) 769-3288
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-20305 | CA | MD | Clinical Psychologist |
| 013331 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511308800000",
"number": "1861501405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "773 PINE RIDGE CIR",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922237153",
"telephone_number": "951-769-3288",
"fax_number": "951-769-3288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 S FARRELL DR",
"address_2": "STE C207",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922627944",
"telephone_number": "760-699-6363",
"fax_number": "951-769-6753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "DONALD",
"middle_name": "W.",
"credential": "CP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2017-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY-20305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.