Amanda Gulsrud, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

24771 Issued in CA

Practice address

760 Westwood PLZ
RM 68-237C
Los Angeles, CA 90024-5055

Phone

(310) 825-0575

NPI assigned

Aug 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: agulsrud58396@direct.uclahealth.org

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.

• UCLA

  • Psychiatric Hospital
  • Los Angeles, CA
  • NPI 1659639979
  NPD (past) Authorized official
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1083960413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ",
            "address_2": "RM 68-237C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "310-825-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ",
            "address_2": "RM 68-237C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "310-825-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULSRUD",
        "first_name": "AMANDA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083960413",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvette Gulesserian, DDS
• Estelita A Gulick, R.N.
• Marvin Gulley
• Cricket Cheyenne Gullickson
• Cheryl M Gully, LCSW
• Maria Gultom
• Nar Vicken Gulvartian
• Elizabeth Ragus Pacol Gum, PT, DPT
• Winley Gumayagay
• Joslyn Lois Gumbs, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.