Active NPI
Ivan West Greenspan, PSY.D.
- Clinical Psychologist
- Sherman Oaks, CA
National Provider Identifier
1013154301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY18686
- Practice address
- 4849 Van Nuys Blvd
Sherman Oaks, CA 91403-2110 - Phone
- (818) 970-3172
- NPI assigned
- Jan 8, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18686 | CA | Primary |
Addresses
Primary practice location
4849 Van Nuys Blvd
Sherman Oaks, CA 91403-2110
Mailing address
6022 Evenhaim LN
Tarzana, CA 91356-1162
Phone (818) 970-3172
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18686 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychmed West a Psychological Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Tarzana, CA
- NPI 1932323169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1013154301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6022 EVENHAIM LN",
"city": "TARZANA",
"state": "CA",
"postal_code": "913561162",
"telephone_number": "818-970-3172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4849 VAN NUYS BLVD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914032110",
"telephone_number": "818-970-3172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENSPAN",
"first_name": "IVAN",
"middle_name": "WEST",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-08",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.