DR. GREGORY ERNEST KOCH PSY.D. NPI 1730180852

NPI Information

NPI: 1730180852
Provider Name: DR. GREGORY ERNEST KOCH, PSY.D.
Classification: Psychologist - 103TB0200X
Entity Type: Individual

Specialization: Cognitive & Behavioral

Address:
4081 STEPHENS ST
SAN DIEGO, CA
ZIP 92103
Phone: (888) 588-7836
Get Directions

DR. Gregory Ernest Koch, PSY.D. 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. DR. Gregory Ernest Koch, PSY.D. NPI is 1730180852. 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:

4081 STEPHENS ST
SAN DIEGO, CA
ZIP 92103-242
Phone: (888) 588-7836
Fax: (888) 588-7836

The enumeration date for this NPI number is 8/10/2005 and was last updated on 7/8/2007.

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	PSY19917	CALIFORNIA	Yes
2	103TC0700X	Psychologist	Clinical	PSY19917	CALIFORNIA	X
3	103TC2200X	Psychologist	Clinical Child & Adolescent	PSY19917	CALIFORNIA	X
4	103T00000X	Psychologist		PSY19917	CALIFORNIA	X
5	103TP2701X	Psychologist	Group Psychotherapy	PSY19917	CALIFORNIA	X

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	CP19917	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
2	PSY199170	MEDICAID	CALIFORNIA
3	0PL199170	OTHER	CALIFORNIA	BLUE SHIELD
4	11397904	OTHER	CALIFORNIA	CAQH
5	5551998	OTHER	CALIFORNIA	FIRSTHEALTH/CCN

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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