Individual provider Active NPI

Andrew E. Damian

  • Health Psychologist
  • Hayward, CA
National Provider Identifier
1891120002
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
License
PSY31556 Issued in CA
Practice address
24301 Southland Dr Ste 200
Hayward, CA 94545-1541
Phone
(510) 342-5721
NPI assigned
Sep 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X F4744951 CA
Clinical Psychologist 103TC0700X PSY31556 CA
Health Psychologist 103TH0004X PSY31556 CA Primary

Addresses

Primary practice location

24301 Southland Dr Ste 200
Hayward, CA 94545-1541

Mailing address

3440 25TH St Apt 304
San Francisco, CA 94110-3857
Phone (708) 724-2291

Other practice location 1

101 Broadway
Richmond, CA 94804-1945
Phone (510) 235-1516

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

State licenses

LicenseStateTypeSpecialty
F4744951CAMDCounselor
PSY31556CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Mind Psychology LTD CurrentSince May 3, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1891120002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 25TH ST APT 304",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103857",
            "telephone_number": "708-724-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24301 SOUTHLAND DR STE 200",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945451541",
            "telephone_number": "510-342-5721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Broadway",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948041945",
            "country_code": "US",
            "telephone_number": "510-235-1516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMIAN",
        "first_name": "ANDREW",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-06",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "F4744951",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31556",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "PSY31556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.