Individual provider Active NPI

Edward John Bitter, PH.D.

  • Clinical Psychologist
  • Tarzana, CA
National Provider Identifier
1124043179
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY043401 Issued in CA
Practice address
19634 Ventura Blvd
Ste. 325
Tarzana, CA 91356-2966
Phone
(818) 345-2341
Fax
(818) 345-7736
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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 PSY043401 CA Primary

Addresses

Primary practice location

19634 Ventura Blvd
Ste. 325
Tarzana, CA 91356-2966

Mailing address

17115 Williams Oak Dr
Cypress, TX 77433-4543
Phone (310) 277-0190

Other identifiers 2

IdentifierTypeStateIssuer
5422000PL43400OtherCABLUE SHIELD OF CALIFORNIA
PSY043401MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20111208000267 TX Practitioner - Clinical Psychologist 7214019777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BHC- Behavioral Health Consultants, IncGroup PAC ID 4587618319, 6 clinicians

Practice addresses (Care Compare)

9525 Katy Fwy
Suite 312
Houston, TX 77024-1467
Phone (713) 463-9449

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY043401CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
BHC- Behavioral Health Consultants, Inc Clinical CurrentSince Apr 1, 2020 Accepting new patients

Locations

9525 Katy Fwy
Ste 312
Houston, TX 77024
Phone (713) 343-3953

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1124043179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17115 WILLIAMS OAK DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774334543",
            "telephone_number": "310-277-0190",
            "fax_number": "281-758-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19634 VENTURA BLVD",
            "address_2": "STE. 325",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562966",
            "telephone_number": "818-345-2341",
            "fax_number": "818-345-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITTER",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY043401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "5422000PL43400",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY043401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.