Kenneth Raven, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY6491 Issued in CA

Practice address

25 W. Rolling Oaks Dr.
Suite #107
Thousand Oaks, CA 91361-1003

Phone

(805) 497-7001

Fax

(805) 498-8076

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1003955311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W. ROLLING OAKS DR.",
            "address_2": "SUITE #107",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611003",
            "telephone_number": "805-497-7001",
            "fax_number": "805-498-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W. ROLLING OAKS DR.",
            "address_2": "SUITE #107",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611003",
            "telephone_number": "805-497-7001",
            "fax_number": "805-498-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVEN",
        "first_name": "KENNETH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY6491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquie Z. Randall, MS
• Carrie Rasmussen, M.S. LMFT
• Teresa Anne Rattray, PH.D.
• Bridget Rau, NONE
• Jennifer Rau
• Pegah Raven, OD
• Sheila Ray, BA
• Raymond L Lam MD Inc
• Ahsan Syed Raza, D.D.S.
• Timothy Jerad Rearick, MD

• Clinical Psychologist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.