Walter Philip Greenberg, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY8699 Issued in CA

Practice address

11645 Wilshire Blvd
Suite 1065
Los Angeles, CA 90025-1708

Phone

(310) 824-2087

Fax

(310) 441-0299

NPI assigned

Jan 30, 2007

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

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.

Opted out of Medicare

Yes, effective Oct 1, 2016 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063559227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 1065",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-824-2087",
            "fax_number": "310-441-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 1065",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-824-2087",
            "fax_number": "310-441-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "WALTER",
        "middle_name": "PHILIP",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia B Greenberg, P.T.
• Mark Jeffrey Greenberg, M.A.
• Micah Greenberg
• Michael Joel Greenberg, PHD
• Stephen Greenberg, M.D.
• Yonatan Aryeh Greenberg
• Ashton Rhodes Greenblatt, PA-C
• Douglas Greenblatt, M.D.
• Gail Alice Greendale, MD
• Aaron Greene, M.D.

• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.