DR. J PATRICK GANNON PHD
NPI 1790073880
Psychologist - Clinical in San Francisco, CA

Q: What is J Gannon's NPI number?

The NPI number for J Gannon is 1790073880. It was assigned to this individual provider in the NPPES registry on July 11, 2011.

Q: What is J Gannon's specialty?

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

Q: Is J Gannon enrolled in Medicare?

No. J Gannon has opted out of Medicare through December 27, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for J Gannon was last updated on July 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since July 11, 2011Opted out of Medicare · through Dec 27, 2027

417 SPRUCE ST, SAN FRANCISCO, CA 94118(415) 751-8927 Get Directions Write a Review

NPPES record last updated: July 11, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. J Patrick Gannon Phd NPPES

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

DR. J PATRICK GANNON PHD (NPI 1790073880) is an individual clinical provider in San Francisco, California, licensed in California (PSY7201) and active in the NPI registry since July 2011. He has opted out of Medicare through December 27, 2027.

NPPES Registry Identity

NPI1790073880

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. J PATRICK GANNONCredential: PHD

Location Address417 SPRUCE STSan Francisco, CA 94118-1711

Mailing Address417 Spruce StSan Francisco, CA 94118-1711 · (415) 751-8927

Phone(415) 751-8927

Sole ProprietorYes

Enumeration DateJuly 11, 2011

✔ NPI 1790073880 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 · PSY7201

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.

417 SPRUCE ST, San Francisco, CA 94118

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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

Dr. J Patrick Gannon Phd 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 December 27, 2025 through December 27, 2027.

Opt-Out Effective DateDecember 27, 2025

Opt-Out In Effect ThroughDecember 27, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ADRIENNE ELIZABETH AMUNDSEN PH.D.

Psychologist