Active NPI
Odette Boyd, PA
- Psychologist
- Anaheim, CA
National Provider Identifier
1003420142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 94024879
- Practice address
- 5101 E la Palma Ave Ste 100
Anaheim, CA 92807-2056 - Phone
- (442) 229-5636
- NPI assigned
- Sep 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 94024879 | CA | Primary |
Addresses
Primary practice location
5101 E la Palma Ave Ste 100
Anaheim, CA 92807-2056
Mailing address
10808 Foothill Blvd # 626
Rancho Cucamonga, CA 91730-3889
Phone (424) 230-9276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94024879 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599264000000",
"number": "1003420142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10808 FOOTHILL BLVD # 626",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917303889",
"telephone_number": "424-230-9276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5101 E LA PALMA AVE STE 100",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928072056",
"telephone_number": "442-229-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "ODETTE",
"name_prefix": "Dr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-05",
"last_updated": "2020-09-05",
"certification_date": "2020-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "94024879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.