Individual provider Active NPI

Regina Govlich

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1114359452
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34842 Issued in CA
Practice address
3600 Wilshire Blvd Ste 2200
Los Angeles, CA 90010-2632
Phone
(213) 382-4400
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY34842 CA Primary
Rehabilitation Practitioner 225400000X
Rehabilitation Counselor 225C00000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3600 Wilshire Blvd Ste 2200
Los Angeles, CA 90010-2632

Mailing address

7111 Santa Monica Blvd Ste B-202
West Hollywood, CA 90046-3445

Other practice location 1

3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533
Phone (213) 381-1250

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
I20240617002145 CA Practitioner - Clinical Psychologist 5395288534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pure Autism Counseling Center IncGroup PAC ID 4284967167, 11 clinicians

Practice addresses (Care Compare)

17702 Sierra Hwy
Santa Clarita, CA 91351-1635
Phone (888) 770-5222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY34842CAMDClinical Psychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1114359452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 SANTA MONICA BLVD STE B-202",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900463445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 WILSHIRE BLVD STE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102632",
            "telephone_number": "213-382-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3580 Wilshire Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900102533",
            "country_code": "US",
            "telephone_number": "213-381-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOVLICH",
        "first_name": "REGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34842",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.