Individual provider Active NPI

Robert Duff, PH.D.

  • Clinical Neuropsychologist
  • Camarillo, CA
National Provider Identifier
1083149769
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY 29147 Issued in CA
Practice address
445 Rosewood Ave
Suite K2
Camarillo, CA 93010-5929
Phone
(805) 988-6197
NPI assigned
May 1, 2017
Last updated
May 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY 29147 CA Primary
Clinical Psychologist 103TC0700X PSY 29147 CA

Addresses

Primary practice location

445 Rosewood Ave
Suite K2
Camarillo, CA 93010-5929

Mailing address

445 Rosewood Ave
Suite K2
Camarillo, CA 93010-5929

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
I20170601002335 CA Practitioner - Clinical Psychologist 9537436183 Reassigns benefits to 1 organization
Practice locations: Ojai, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Erik Lande PHD a Professional Psychological CorporationGroup PAC ID 0648496125, 4 clinicians

Practice addresses (Care Compare)

1200 Paseo Camarillo
Suite 245
Camarillo, CA 93010-6085
Phone (805) 988-6197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 29147CAMDClinical Psychologist
29147CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Erik Lande, PHD, a Professional Psychological Corporation Clinical Neuropsychologist CurrentSince May 7, 2017 Accepting new patients

Locations

445 Rosewood Ave
Ste K2
Camarillo, CA 93010
Phone (805) 988-6167

1200 Paseo Camarillo
Ste 245
Camarillo, CA 93010
Phone (805) 482-7866

Organizations & group practices 1

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1083149769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 ROSEWOOD AVE",
            "address_2": "SUITE K2",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 ROSEWOOD AVE",
            "address_2": "SUITE K2",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105929",
            "telephone_number": "805-988-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFF",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 29147",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 29147",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.