Individual provider Active NPI

Stephen J. Smith, PSY.D.

  • Clinical Psychologist
  • Burbank, CA
National Provider Identifier
1043532088
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22832 Issued in CA
Practice address
2600 West Olive Avenue
5TH Floor
Burbank, CA 91505
Phone
(818) 391-9140
NPI assigned
Feb 18, 2010
Last updated
May 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 22832 CA
Adult Development & Aging Psychologist 103TA0700X 22832 CA
Cognitive & Behavioral Psychologist 103TB0200X 22832 CA
Clinical Psychologist 103TC0700X 22832 CA
Clinical Psychologist 103TC0700X PSY22832 CA Primary
Clinical Child & Adolescent Psychologist 103TC2200X 22832 CA
Group Psychotherapy Psychologist 103TP2701X 22832 CA
Behavior Analyst 103K00000X 22832 CA

Addresses

Primary practice location

2600 West Olive Avenue
5TH Floor
Burbank, CA 91505

Mailing address

2600 West Olive Avenue
5TH Floor
Burbank, CA 91505
Phone (818) 391-9140

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190715003004 CA Practitioner - Clinical Psychologist 0345575239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY22832CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Autism Counseling Center Inc CurrentSince Mar 13, 2019 Accepting new patients
Stephen J. Smith Past Accepting new patients

Locations

17702 Sierra Hwy
Santa Clarita, CA 91351
Phone (888) 770-5222

19981 Soledad Canyon Rd
Santa Clarita, CA 91351
Phone (661) 360-7730

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19641/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1043532088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WEST OLIVE AVENUE",
            "address_2": "5TH FLOOR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91505",
            "telephone_number": "818-391-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WEST OLIVE AVENUE",
            "address_2": "5TH FLOOR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91505",
            "telephone_number": "818-391-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-18",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "22832",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "22832",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "22832",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "22832",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22832",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "22832",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "22832",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "22832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.