Active NPI
David Charles Beck, M.D.
- Child & Adolescent Psychiatry Physician
- Sebastopol, CA
National Provider Identifier
1871653634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- G040950
- Practice address
- 9707 Ross Station Rd
Sebastopol, CA 95472-2136 - Phone
- (707) 887-2315
- Fax
- (707) 887-2315
- NPI assigned
- Dec 11, 2006
- Last updated
- Sep 25, 2007
- 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | G040950 | CA | Primary |
Addresses
Primary practice location
9707 Ross Station Rd
Sebastopol, CA 95472-2136
Mailing address
9707 Ross Station Rd
Sebastopol, CA 95472-2136
Phone (707) 887-2315
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G040950 | CA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1871653634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9707 ROSS STATION RD",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954722136",
"telephone_number": "707-887-2315",
"fax_number": "707-887-2315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9707 ROSS STATION RD",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954722136",
"telephone_number": "707-887-2315",
"fax_number": "707-887-2315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECK",
"first_name": "DAVID",
"middle_name": "CHARLES",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "G040950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.