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JOHN DAVIS MCKELLAR PH.D. NPI 1184893778


NPI Information

NPI: 1184893778
Provider Name: JOHN DAVIS MCKELLAR, PH.D.
Classification: Psychologist - 103TA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

PECOS Registration: Yes

Address:
15047 LOS GATOS BLVD
SUITE 200
LOS GATOS, CA
ZIP 95032
Phone: (408) 364-6799
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John Davis Mckellar, PH.D. is an addiction (substance use disorder) psychologist in Los Gatos, CA with 23 years of experience. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. John Davis Mckellar, PH.D. NPI is 1184893778. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduation Year:2001

The provider's business location address is:

15047 LOS GATOS BLVD
SUITE 200
LOS GATOS, CA
ZIP 95032-054
Phone: (408) 364-6799
Fax: (408) 378-4510

The NPI 1184893778 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 2/27/2008 and was last updated on 7/11/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0400XPsychologistAddiction (Substance Use Disorder)18966CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CA122627MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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