Individual provider Active NPI

Robert L Whitcomb, PSY.D.

  • Psychologist
  • Fullerton, CA
National Provider Identifier
1124204920
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 10754 Issued in CA
Practice address
213 N Pomona Ave
Fullerton, CA 92832-1926
Phone
(714) 447-8011
Fax
(714) 871-2203
NPI assigned
Jan 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 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 PSY 10754 CA Primary

Addresses

Primary practice location

213 N Pomona Ave
Fullerton, CA 92832-1926

Mailing address

213 N Pomona Ave
Fullerton, CA 92832-1926
Phone (714) 447-8011

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
I20200103001950 CA Practitioner - Clinical Psychologist 5890837009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

213 N Pomona Ave
Fullerton, CA 92832-1926
Phone (562) 587-3851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PSY 10754CAMDPsychologist
10754CAMDPhysical Therapy Assistant

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": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1124204920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N POMONA AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321926",
            "telephone_number": "714-447-8011",
            "fax_number": "714-871-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N POMONA AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321926",
            "telephone_number": "714-447-8011",
            "fax_number": "714-871-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITCOMB",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 10754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.