DR. JOSEPH PATRICK GANNON PH.D. NPI 1467440347

NPI Information

NPI: 1467440347
Provider Name: DR. JOSEPH PATRICK GANNON, PH.D.
Classification: Psychologist - 103TB0200X
Entity Type: Individual

Specialization: Cognitive & Behavioral

PECOS Registration: Yes

Address:
4445 EASTGATE MALL STE 200
SAN DIEGO, CA
ZIP 92121
Phone: (858) 705-5439
Get Directions

DR. Joseph Patrick Gannon, PH.D. is a cognitive and behavioral psychologist in San Diego, CA with 36 years of experience. 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. DR. Joseph Patrick Gannon, PH.D. NPI is 1467440347. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

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

The NPI 1467440347 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 10/13/2005 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TB0200X	Psychologist	Cognitive & Behavioral	PSY12034	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	OPL120340	OTHER	CALIFORNIA	BLUE SHIELD/BLUE CROSS

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

NPI Synchronization or Removal

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