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JONATHAN GONICK-HALLOWS
NPI 1730591835
Psychologist - Clinical in Sebastopol, CA

Active since May 22, 2014Opted out of Medicare · through Jul 1, 2028
8380 GERMONE RD, SEBASTOPOL, CA 95472(707) 823-5388 Get Directions Write a Review

NPPES record last updated: May 22, 2014. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Jonathan Gonick-hallows NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN GONICK-HALLOWS (NPI 1730591835) is an individual clinical provider in Sebastopol, California, licensed in California (PSY11183) and active in the NPI registry since May 2014. He has opted out of Medicare through July 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1730591835
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameJONATHAN GONICK-HALLOWS
Location Address8380 GERMONE RDSebastopol, CA 95472-4008
Mailing Address8380 Germone RdSebastopol, CA 95472-4008 · (707) 823-5388
Phone(707) 823-5388
Sole ProprietorYes
Enumeration DateMay 22, 2014
✔ NPI 1730591835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY11183
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
8380 GERMONE RD, Sebastopol, CA 95472
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jonathan Gonick-hallows has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2024 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2024
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Gonick-hallows's NPI number?

The NPI number for Jonathan Gonick-hallows is 1730591835. It was assigned to this individual provider in the NPPES registry on May 22, 2014.

Where is Jonathan Gonick-hallows located?

Jonathan Gonick-hallows practices at 8380 Germone Rd, Sebastopol, CA 95472. The listed phone number is (707) 823-5388.

What is Jonathan Gonick-hallows's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jonathan Gonick-hallows enrolled in Medicare?

No. Jonathan Gonick-hallows has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jonathan Gonick-hallows was last updated on May 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.