Individual provider Active NPI

Martin Scott Fishman, PH.D.

  • Clinical Psychologist
  • Westlake Village, CA
National Provider Identifier
1093931586
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9493 Issued in CA
Practice address
32107 Lindero Canyon Rd
#134
Westlake Village, CA 91361-4222
Phone
(818) 706-1903
Fax
(818) 991-5922
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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 PSY9493 CA Primary

Addresses

Primary practice location

32107 Lindero Canyon Rd
#134
Westlake Village, CA 91361-4222

Mailing address

32107 Lindero Canyon Rd
Ste 210
Westlake Village, CA 91361-4281
Phone (818) 706-1903

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
I20120410000553 CA Practitioner - Clinical Psychologist 7214198720 Practice locations: Westlake Village, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32107 Lindero Canyon Rd
Suite 210
Westlake Village, CA 91361-4281
Phone (818) 706-1903

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY9493CAMDClinical Psychologist
9493CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1093931586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32107 LINDERO CANYON RD",
            "address_2": "STE 210",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614281",
            "telephone_number": "818-706-1903",
            "fax_number": "818-991-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32107 LINDERO CANYON RD",
            "address_2": "#134",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614222",
            "telephone_number": "818-706-1903",
            "fax_number": "818-991-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "MARTIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.