John Davodi

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

1260 Morena Blvd Ste 200
San Diego, CA 92110-3850

Phone

(619) 398-3261

NPI assigned

Apr 28, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1497978910
  NPD (past)

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1962023184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 MORENA BLVD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103850",
            "telephone_number": "619-398-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 MORENA BLVD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103850",
            "telephone_number": "619-398-3261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 Morena Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921103844",
            "country_code": "US",
            "telephone_number": "619-398-3261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVODI",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yomara Davis, MSW
• Gary L Davison, OD
• Jordan Davison
• Michelle Davison
• Sophia Davit
• Marjan Davoudi, PSY.D.
• Touran Davoudi, D.D.S
• Vladislav Davydov
• Mariyah Daway
• John Graves Dawkins, M.D

• Clinical Child & Adolescent Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.