Individual provider Active NPI

Alan Dana Caggiano, PSYD

  • Clinical Psychologist
  • Richmond, CA
National Provider Identifier
1881864742
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
21255 Issued in CA
Practice address
4212 Nevin Ave
Richmond, CA 94805-2342
Phone
(510) 338-2752
NPI assigned
Mar 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 21255 CA Primary

Addresses

Primary practice location

4212 Nevin Ave
Richmond, CA 94805-2342

Mailing address

PO Box 291
Fort Dick, CA 95538-0291
Phone (510) 338-2752

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105003969 CA Practitioner - Clinical Psychologist 4486660347 Practice locations: Fresno, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Fresno, CA 93720
Phone (650) 430-3130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21255CAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1881864742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291",
            "city": "FORT DICK",
            "state": "CA",
            "postal_code": "955380291",
            "telephone_number": "510-338-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 NEVIN AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948052342",
            "telephone_number": "510-338-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAGGIANO",
        "first_name": "ALAN",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "21255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

Verify at the official NPI Registry.