Active NPI
Dylan Morris
- Clinical Psychologist
- San Rafael, CA
National Provider Identifier
1982332722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY35163
- Practice address
- 750 Las Gallinas Ave
San Rafael, CA 94903-3438 - Phone
- (415) 475-2439
- NPI assigned
- Aug 10, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY35163 | CA | Primary |
Addresses
Primary practice location
750 Las Gallinas Ave
San Rafael, CA 94903-3438
Mailing address
377 Butterfield Rd
San Anselmo, CA 94960-1222
Phone (415) 717-6685
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Previously, effective Sep 4, 2024 through Sep 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY35163 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1982332722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "377 BUTTERFIELD RD",
"city": "SAN ANSELMO",
"state": "CA",
"postal_code": "949601222",
"telephone_number": "415-717-6685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 LAS GALLINAS AVE",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949033438",
"telephone_number": "415-475-2439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "DYLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-10",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY35163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.