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JOSEPH GANNON PH.D. A PROFESSIONAL PSYCHOLOGY CORPORATION NPI 1245277227


NPI Information

NPI: 1245277227
Provider Name: JOSEPH GANNON, PH.D. A PROFESSIONAL PSYCHOLOGY CORPORATION
Classification: Psychologist - 103TB0200X
Entity Type: Organization

Specialization: Cognitive & Behavioral

Address:
4445 EASTGATE MALL PMB 843
SUITE 200
SAN DIEGO, CA
ZIP 92121
Phone: (858) 705-5439
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JOSEPH GANNON, PH.D. A PROFESSIONAL PSYCHOLOGY CORPORATION is a cognitive and behavioral psychologist in San Diego, CA. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. JOSEPH GANNON, PH.D. A PROFESSIONAL PSYCHOLOGY CORPORATION NPI is 1245277227. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4445 EASTGATE MALL PMB 843
SUITE 200
SAN DIEGO, CA
ZIP 92121-979
Phone: (858) 705-5439
Fax: (858) 771-1078

The provider's authorized official is Joseph Patrick Gannon .
The authorized official title is President and has the following contact phone number (858) 705-5439.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 7/30/2022.


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
1103TC0700XPsychologistClinicalPSY12034CALIFORNIANo
2103TB0200XPsychologistCognitive & BehavioralYes

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
1OPL120340OTHERCALIFORNIABLUE SHIELD PROVIDER IDEN

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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