Active NPI
Stephen M. Fitch, PHD.
- Clinical Psychologist
- Camarillo, CA
National Provider Identifier
1104851963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 13676
- Practice address
- 1601 Carmen Drive
Suite #111
Camarillo, CA 93010-3103 - Phone
- (805) 987-7006
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 13676 | CA | Primary |
| Counseling Psychologist | 103TC1900X | PSY 13676 | CA | |
| Family Psychologist | 103TF0000X | PSY 13676 | CA | |
| Psychologist | 103T00000X | PSY 13676 | CA |
Addresses
Primary practice location
1601 Carmen Drive
Suite #111
Camarillo, CA 93010-3103
Mailing address
1601 Carmen Drive
Suite #111
Camarillo, CA 93010-3103
Phone (805) 987-7006
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY 136760 | Medicaid | CA | |
| OPL136760 | Other | CA | BLUE SHIELD OF CALIFORNIA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 13676 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282262400000",
"number": "1104851963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 CARMEN DRIVE",
"address_2": "SUITE #111",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930103103",
"telephone_number": "805-987-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 CARMEN DRIVE",
"address_2": "SUITE #111",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930103103",
"telephone_number": "805-987-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITCH",
"first_name": "STEPHEN",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PHD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2010-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 13676",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY 13676",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "CA",
"license": "PSY 13676",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 13676",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY 136760",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CALIFORNIA",
"identifier": "OPL136760",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.