Melissa Fay Gondek, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY23451 Issued in CA

Practice address

4055 E Thousand Oaks Blvd
Suite 215
Westlake Village, CA 91362-3600

Phone

(805) 795-1238

NPI assigned

Aug 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Melissa Fay Bubar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1144413477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 E THOUSAND OAKS BLVD",
            "address_2": "SUITE 215",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623600",
            "telephone_number": "805-795-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 E THOUSAND OAKS BLVD",
            "address_2": "SUITE 215",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623600",
            "telephone_number": "805-795-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONDEK",
        "first_name": "MELISSA",
        "middle_name": "FAY",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY23451",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY23451",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY23451",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY23451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BUBAR",
            "middle_name": "FAY",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barton Jay Goldsmith, PH.D.
• Allen Stuart Goldstein
• Howard Roger Goldstine, MD
• Stephen J Gomberg, M.D.
• Julie Gomez
• Ashley Gonzalez Vasquez
• Lindsay Gooze
• Joanne Gordon, LMFT
• Kenneth Steven Gordon, PHD
• Renee Jenine Gordon, D.C.

• Clinical Child & Adolescent Psychologist in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.

Verify at the official NPI Registry.