Gregory Knight Travis, PHD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

PSY12181 Issued in CA

Practice address

6310 San Vicente Blvd Ste 410
Los Angeles, CA 90048-5457

Phone

(323) 935-3885

NPI assigned

Mar 22, 2025

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 3, 2025 through Dec 3, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1742601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1033910203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 W 28TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900183049",
            "telephone_number": "323-935-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 SAN VICENTE BLVD STE 410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485457",
            "telephone_number": "323-935-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "GREGORY",
        "middle_name": "KNIGHT",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-22",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY12181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travelers Aid Society of Los Angeles, California
• Malena Traverso
• Richard Traviesio
• Roberto Travieso, M.D.
• Travis Winsor M D Incorporated
• Sheila Traviss, MFT
• Christina Travnitz, LCSW
• Margaret M Traxler, PT
• Ilanna Trayber
• Alan J Traylor, CADPT

• Cognitive & Behavioral Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.