Southland Psychology Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

16618 Issued in CA

Legal business name

SOUTHLAND PSYCHOLOGY INC

Practice address

15300 Ventura Blvd Ste 301
Sherman Oaks, CA 91403-3103

Phone

(310) 551-8535

NPI assigned

Sep 6, 2017

Organization subpart

No

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

Authorized official

Name

Jane Beresford, PSY.DNPI 1467573378

Title

Psy.D, Owner

Phone

(310) 551-8535

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bethany Walters

  • Clinical Psychologist
  • West Hills, CA
  • NPI 1669223640
  Medicare reassignment NPD
• Jane Clare Beresford, PSYD

  • Clinical Psychologist
  • Sherman Oaks, CA
  • NPI 1467573378
  NPD Authorized official

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1043738412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 VENTURA BLVD STE 301",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033103",
            "telephone_number": "310-551-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 VENTURA BLVD STE 301",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033103",
            "telephone_number": "310-551-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-06",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "BERESFORD",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "PSY.D, OWNER",
        "authorized_official_telephone_number": "310-551-8535",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "16618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Sherman Oaks, CA
• Providers in Sherman 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 Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.