Active NPI
Lydia S Bangtson, PH.D.
- Clinical Psychologist
- Glendale, CA
National Provider Identifier
1093859035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 18278
- Practice address
- 222 W Eulalia St
Suite 301
Glendale, CA 91204-2849 - Phone
- (818) 240-0108
- Fax
- (818) 240-0301
- NPI assigned
- Feb 15, 2007
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 18278 | CA | Primary |
| Forensic Psychologist | 103TF0200X | PSY18278 | CA |
Addresses
Primary practice location
222 W Eulalia St
Suite 301
Glendale, CA 91204-2849
Mailing address
222 W Eulalia St
Suite 301
Glendale, CA 91204-2849
Phone (818) 240-0108
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 18278 | CA | MD | Clinical Psychologist |
| PSY18278 | CA | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1093859035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 W EULALIA ST",
"address_2": "SUITE 301",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042849",
"telephone_number": "818-240-0108",
"fax_number": "818-240-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W EULALIA ST",
"address_2": "SUITE 301",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042849",
"telephone_number": "818-240-0108",
"fax_number": "818-240-0301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGTSON",
"first_name": "LYDIA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 18278",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "PSY18278",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.