Individual provider Active NPI

Bahram Katouzian, PHD

  • Psychologist
  • Palo Alto, CA
National Provider Identifier
1104974278
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY19468 Issued in CA
Practice address
550 Hamilton Ave
Suite 229
Palo Alto, CA 94301-2010
Phone
(650) 330-0492
Fax
(650) 329-1546
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY19468 CA Primary

Addresses

Primary practice location

550 Hamilton Ave
Suite 229
Palo Alto, CA 94301-2010

Mailing address

550 Hamilton Ave
Suite 229
Palo Alto, CA 94301-2010
Phone (650) 330-0492

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

LicenseStateTypeSpecialty
PSY19468CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1104974278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 HAMILTON AVE",
            "address_2": "SUITE 229",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012010",
            "telephone_number": "650-330-0492",
            "fax_number": "650-329-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 HAMILTON AVE",
            "address_2": "SUITE 229",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012010",
            "telephone_number": "650-330-0492",
            "fax_number": "650-329-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATOUZIAN",
        "first_name": "BAHRAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.