Individual provider Active NPI

Elizabeth Fox Butler, PSY.D.

  • Psychologist
  • Pleasanton, CA
National Provider Identifier
1053628792
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSB94020676 Issued in CA
Practice address
4713 1St St
Ste 254
Pleasanton, CA 94566-7361
Phone
(925) 421-6868
Fax
(925) 462-0545
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSB94020676 CA Primary

Addresses

Primary practice location

4713 1St St
Ste 254
Pleasanton, CA 94566-7361

Mailing address

4713 1St St
Ste 254
Pleasanton, CA 94566-7361
Phone (925) 421-6868

Other names 1

  • Elizabeth FB Osborne Former name

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

LicenseStateTypeSpecialty
PSB94020676CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1053628792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4713 1ST ST",
            "address_2": "STE 254",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667361",
            "telephone_number": "925-421-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4713 1ST ST",
            "address_2": "STE 254",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667361",
            "telephone_number": "925-421-6868",
            "fax_number": "925-462-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "ELIZABETH",
        "middle_name": "FOX",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94020676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "OSBORNE",
            "middle_name": "FB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.