Individual provider Active NPI

Norman Solomowitz, PH.D.

  • Clinical Psychologist
  • Stockton, CA
National Provider Identifier
1891822912
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 6514 Issued in CA
Practice address
4227 Annandale Dr
Stockton, CA 95219-1778
Phone
(209) 952-9475
Fax
(209) 952-9475
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY 6514 CA Primary

Addresses

Primary practice location

4227 Annandale Dr
Stockton, CA 95219-1778

Mailing address

4227 Annandale Dr
Stockton, CA 95219-1778
Phone (209) 952-9475

Other identifiers 1

IdentifierTypeStateIssuer
PSY 6514OtherCASTATE LICENSE

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

LicenseStateTypeSpecialty
PSY 6514CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891822912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 ANNANDALE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191778",
            "telephone_number": "209-952-9475",
            "fax_number": "209-952-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 ANNANDALE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191778",
            "telephone_number": "209-952-9475",
            "fax_number": "209-952-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMOWITZ",
        "first_name": "NORMAN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 6514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PSY 6514",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.