Douglas Novotny, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

23447 Issued in CA

Practice address

6150 Center Street
Clayton, CA 94517-0486

Phone

(925) 722-4540

NPI assigned

Jan 29, 2007

Last updated

Aug 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Novotny Psychotherapy, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clayton, CA
  • NPI 1407631039
  Medicare reassignment NPD Authorized official
• Assessment and Development Center of Sacramento

  dba ADCSac

  • Clinical Psychologist
  • Sacramento, CA
  • NPI 1750916177
  NPD
• Early Childhood Mental Health Program

  • Community/Behavioral Health Agency
  • Richmond, CA
  • NPI 1740332071
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1962548800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 CENTER ST",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945175099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 CENTER STREET",
            "city": "CLAYTON",
            "state": "CA",
            "postal_code": "945170486",
            "telephone_number": "925-722-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "DOUGLAS",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "23447",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "23447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seong Kit Moore, PHARMD
• William L Morfeld, M.D.
• Chris John Murray, RADT
• Dana T Nguyen, RPH
• Novotny Psychotherapy, P.C.
• Larissa Michele Oberholtzer-Gallagher, RN
• Carlos J Padilla
• Ashvinbhai Patel
• Zeenal Patel
• James Perry

• Clinical Psychologist in Clayton, CA
• Providers in Clayton, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.