Active NPI
Jamie Michelle Deluca, PHD
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1881117489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY29363
- Practice address
- 200 W Arbor Dr
San Diego, CA 92103-9000 - Phone
- (858) 534-7792
- NPI assigned
- Jul 25, 2017
- Last updated
- Jul 14, 2021
- Sex
- Female
- Sole proprietor
- No
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 | PSY29363 | CA | Primary |
Addresses
Primary practice location
200 W Arbor Dr
San Diego, CA 92103-9000
Mailing address
PO Box 232410
San Diego, CA 92193-2410
Other names 1
- Jamie Michelle Gannon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY29363 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Clinical | Current | Accepting new patients |
| Regents of the University of California | Current | Accepting new patients |
Locations
8950 Villa La Jolla Dr
Ste C101
La Jolla, CA 92037
Phone (858) 249-1680
File 57326
Los Angeles, CA 90074
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626220800000",
"number": "1881117489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232410",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921932410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ARBOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921039000",
"telephone_number": "858-534-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELUCA",
"first_name": "JAMIE",
"middle_name": "MICHELLE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-25",
"last_updated": "2021-07-14",
"certification_date": "2021-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY29363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JAMIE",
"last_name": "GANNON",
"middle_name": "MICHELLE",
"code": "1",
"type": "Former Name"
}
]
}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 Jul 14, 2021; 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.