Individual provider Active NPI

Annette Cody, ANNETTE CODY

  • Clinical Psychologist
  • Davis, CA
National Provider Identifier
1922134121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16060 Issued in CA
Practice address
1747 Oak Ave
Davis, CA 95616-1004
Phone
(530) 753-9044
Fax
(530) 758-7099
NPI assigned
Feb 24, 2007
Sex
Female
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 PSY16060 CA Primary

Addresses

Primary practice location

1747 Oak Ave
Davis, CA 95616-1004

Mailing address

1747 Oak Ave
Davis, CA 95616-1004
Phone (530) 753-9044

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
PSY16060CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922134121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 OAK AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956161004",
            "telephone_number": "530-753-9044",
            "fax_number": "530-758-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 OAK AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956161004",
            "telephone_number": "530-753-9044",
            "fax_number": "530-758-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODY",
        "first_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "ANNETTE CODY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, 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.