Individual provider Active NPI

Dwight Jerome Norman Jr., PSY.D

  • Clinical Psychologist
  • Bakersfield, CA
National Provider Identifier
1144504564
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31201 Issued in CA
Practice address
2026 17TH St Ste 101
Bakersfield, CA 93301-4251
Phone
(661) 348-4299
Fax
(661) 215-1872
NPI assigned
Oct 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Clinical Psychologist 103TC0700X 31201 CA Primary

Addresses

Primary practice location

2026 17TH St Ste 101
Bakersfield, CA 93301-4251

Mailing address

8010 Vidius Way
Bakersfield, CA 93313-6429
Phone (661) 348-4299

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
I20200413000789 CA Practitioner - Clinical Psychologist 8022447101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2026 17TH St
Suite 101
Bakersfield, CA 93301-4251
Phone (661) 348-4299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Kern CurrentSince Oct 4, 2024 Accepting new patients
County of Kern CurrentSince Oct 4, 2024 Accepting new patients
Alpha Beta Behavioral Psychological Services Inc. Clinical CurrentSince Feb 13, 2020 Accepting new patients
County of Kern Current Accepting new patients

Locations

2525 N Chester Ave
Bakersfield, CA 93308
Phone (661) 328-4295

2026 17th St
Ste 101
Bakersfield, CA 93301
Phone (661) 322-9772

3400 Cottage Way
Ste G2
Sacramento, CA 95825
Phone (209) 683-8501

Organizations & group practices 4

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": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1144504564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 VIDIUS WAY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933136429",
            "telephone_number": "661-348-4299",
            "fax_number": "661-215-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 17TH ST STE 101",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933014251",
            "telephone_number": "661-348-4299",
            "fax_number": "661-215-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "DWIGHT",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.