Individual provider Active NPI

Anthony Odozi

  • Psychologist
  • Valencia, CA
National Provider Identifier
1063600732
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY33276 Issued in CA
Practice address
25350 Magic Mountain Pkwy Ste 300
Valencia, CA 91355-1356
Phone
(424) 225-0964
NPI assigned
Oct 9, 2007
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY33276 CA Primary
Clinical Psychologist 103TC0700X PSY33276 CA

Addresses

Primary practice location

25350 Magic Mountain Pkwy Ste 300
Valencia, CA 91355-1356

Mailing address

PO Box 882021
San Diego, CA 92168-2021
Phone (424) 225-0964

Other practice location 1

25350 Magic Mountain Pkwy Ste 300
Valencia, CA 91355-1356
Phone (424) 225-0964

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
I20230926004251 CA Practitioner - Clinical Psychologist 9032563945 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY33276CAMDPsychologist
33276CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Neuroserenity Psychological Services, Inc. Clinical CurrentSince Feb 18, 2024 Accepting new patients
Pure Autism Counseling Center Inc CurrentSince Jun 21, 2024 Accepting new patients
Family Psychological Services Inc Psychologist CurrentSince Aug 6, 2023 Accepting new patients

Locations

30495 Canwood St
Ste 101
Agoura Hills, CA 91301
Phone (818) 707-7366

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

25350 Magic Mountain Pkwy
Ste 300
Valencia, CA 91355
Phone (661) 247-9568

Interoperability endpoints

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

Organizations & group practices 3

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": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1063600732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882021",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921682021",
            "telephone_number": "424-225-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25350 MAGIC MOUNTAIN PKWY STE 300",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551356",
            "telephone_number": "424-225-0964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25350 Magic Mountain Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Valencia",
            "state": "CA",
            "postal_code": "913551356",
            "country_code": "US",
            "telephone_number": "424-225-0964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOZI",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33276",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.