Individual provider Active NPI

Steven Michael Razo

  • Clinical Psychologist
  • Beverly Hills, CA
National Provider Identifier
1063786341
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31156 Issued in CA
Practice address
8484 Wilshire Blvd Ste 750
Beverly Hills, CA 90211-3216
Phone
(805) 620-7484
NPI assigned
Mar 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Psychologist 103TC0700X PSY31156 CA Primary

Addresses

Primary practice location

8484 Wilshire Blvd Ste 750
Beverly Hills, CA 90211-3216

Mailing address

1026 Blue Lake Dr
Santa Maria, CA 93454-2435
Phone (805) 266-4657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200827003208 CA Practitioner - Clinical Psychologist 7618394867 Reassigns benefits to 2 organizations
I20231101001764 CA Practitioner - Clinical Psychologist 7618394867 Practice locations: Beverly Hills, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY31156CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Behavioral Health Inc Clinical CurrentSince Nov 4, 2024 Accepting new patients
Psychiatric Services Incorporated CurrentSince Aug 15, 2020 Accepting new patients
TMS Neurohealth West Professional Medical Corporation PastSince Dec 2, 2022 Accepting new patients

Locations

30343 Canwood St
Ste 104
Agoura Hills, CA 91301
Phone (818) 706-9300

30101 Agoura Ct
Ste 240
Agoura Hills, CA 91301
Phone (805) 490-0455

29800 Agoura Rd
Ste 200
Agoura Hills, CA 91301
Phone (818) 706-9300

993 W 7th St
Oxnard, CA 93030
Phone (805) 483-9565

1500 Palma Dr
Fl 2
Ventura, CA 93003
Phone (805) 284-1783

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1063786341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 BLUE LAKE DR",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934542435",
            "telephone_number": "805-266-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8484 WILSHIRE BLVD STE 750",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113216",
            "telephone_number": "805-620-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZO",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-03",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.