Individual provider Active NPI

Gary N. Grossman, PH.D.

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1902038599
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12045 Issued in CA
Practice address
2186 Geary Blvd
Suite 211
San Francisco, CA 94115-3455
Phone
(415) 928-4662
NPI assigned
Aug 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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 PSY12045 CA Primary

Addresses

Primary practice location

2186 Geary Blvd
Suite 211
San Francisco, CA 94115-3455

Mailing address

2186 Geary Blvd
Suite 211
San Francisco, CA 94115-3455
Phone (415) 928-4662

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
I20170413000613 CA Practitioner - Clinical Psychologist 5698928240 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2186 Geary Blvd
Suite 211
San Francisco, CA 94115-3456
Phone (415) 928-4662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12045CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250208000000",
    "number": "1902038599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 GEARY BLVD",
            "address_2": "SUITE 211",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153455",
            "telephone_number": "415-928-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 GEARY BLVD",
            "address_2": "SUITE 211",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153455",
            "telephone_number": "415-928-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "GARY",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-14",
        "last_updated": "2009-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.