Individual provider Active NPI

Bert Meltzer, PH.D.

  • Clinical Psychologist
  • Palm Desert, CA
National Provider Identifier
1053515882
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 3577 Issued in CA
Practice address
78432 Glastonbury Way
Palm Desert, CA 92211-1949
Phone
(909) 563-0252
NPI assigned
Jun 14, 2007
Last updated
Jul 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 3577 CA Primary

Addresses

Primary practice location

78432 Glastonbury Way
Palm Desert, CA 92211-1949

Mailing address

78432 Glastonbury Way
Palm Desert, CA 92211-1949
Phone (909) 563-0252

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 3577CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1053515882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78432 GLASTONBURY WAY",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922111949",
            "telephone_number": "909-563-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78432 GLASTONBURY WAY",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922111949",
            "telephone_number": "909-563-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTZER",
        "first_name": "BERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 3577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.