Active NPI
Jonathan Robert Peretz, PSY.D.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1912184235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 24151
- Practice address
- 801 Portola Dr
Suite 207
San Francisco, CA 94127-1234 - Phone
- (415) 242-9909
- NPI assigned
- Jan 29, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00414000 | NJ | |
| Clinical Psychologist | 103TC0700X | PSY 24151 | CA | Primary |
Addresses
Primary practice location
801 Portola Dr
Suite 207
San Francisco, CA 94127-1234
Mailing address
801 Portola Dr
Suite 207
San Francisco, CA 94127-1234
Phone (415) 242-9909
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 24151 | CA | MD | Clinical Psychologist |
| 35SI00414000 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387238400000",
"number": "1912184235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 PORTOLA DR",
"address_2": "SUITE 207",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941271234",
"telephone_number": "415-242-9909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 PORTOLA DR",
"address_2": "SUITE 207",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941271234",
"telephone_number": "415-242-9909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERETZ",
"first_name": "JONATHAN",
"middle_name": "ROBERT",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-29",
"last_updated": "2013-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00414000",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 24151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.