Individual provider Active NPI

Oleksiy Verezumskyy, PSYD

  • Clinical Psychologist
  • Fullerton, CA
National Provider Identifier
1073292702
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
36764 Issued in CA
Practice address
2001 Deerpark Dr Apt 728
Fullerton, CA 92831-1570
Phone
(818) 288-3146
NPI assigned
Jul 11, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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 36764 CA Primary

Addresses

Primary practice location

2001 Deerpark Dr Apt 728
Fullerton, CA 92831-1570

Mailing address

2001 Deerpark Dr Apt 728
Fullerton, CA 92831-1570
Phone (818) 288-3146

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
940256CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Friends of Family Health Center CurrentSince Oct 15, 2025 Accepting new patients
Friends of Family Health Center CurrentSince Oct 15, 2025 Accepting new patients

Locations

501 S Idaho St
Ste 100
La Habra, CA 90631
Phone (562) 690-0400

1129 W 4th St
Ontario, CA 91762
Phone (909) 363-9300

Organizations & group practices 2

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": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1073292702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 DEERPARK DR APT 728",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311570",
            "telephone_number": "818-288-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 DEERPARK DR APT 728",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311570",
            "telephone_number": "818-288-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEREZUMSKYY",
        "first_name": "OLEKSIY",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "36764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.