Active NPI
Robert Fish, PHYCHOLOGIST
- Psychologist
- Los Angeles, CA
National Provider Identifier
1013261932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY14143
- Practice address
- 522 S San Pedro St
Los Angeles, CA 90013-2102 - Phone
- (213) 486-4050
- NPI assigned
- Oct 30, 2012
- Sex
- Male
- 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 | PSY14143 | CA | Primary |
Addresses
Primary practice location
522 S San Pedro St
Los Angeles, CA 90013-2102
Mailing address
3371 Glendale Blvd
Unit 133
Los Angeles, CA 90039-1825
Phone (213) 484-1186
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 |
|---|---|---|---|
| PSY14143 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1013261932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3371 GLENDALE BLVD",
"address_2": "UNIT 133",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900391825",
"telephone_number": "213-484-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132102",
"telephone_number": "213-486-4050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISH",
"first_name": "ROBERT",
"credential": "PHYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-30",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY14143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.