Active NPI
Robert Eldridge Corb Jr., PH.D.
- Exercise & Sports Psychologist
- Los Angeles, CA
National Provider Identifier
1154575876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exercise & Sports Psychologist
- License
- PSY 17422
- Practice address
- John Wooden Ctr W
Box 951556
Los Angeles, CA 90095-0001 - Phone
- (313) 825-0768
- Fax
- (310) 206-7365
- NPI assigned
- Nov 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exercise & Sports Psychologist | 103TE1100X | PSY 17422 | CA | Primary |
Addresses
Primary practice location
John Wooden Ctr W
Box 951556
Los Angeles, CA 90095-0001
Mailing address
PO Box 912
Los Alamitos, CA 90720-0912
Phone (562) 773-7413
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17422 | CA | MD | Exercise & Sports Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226016000000",
"number": "1154575876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 912",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907200912",
"telephone_number": "562-773-7413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JOHN WOODEN CTR W",
"address_2": "BOX 951556",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900950001",
"telephone_number": "313-825-0768",
"fax_number": "310-206-7365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORB",
"first_name": "ROBERT",
"middle_name": "ELDRIDGE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-07",
"last_updated": "2008-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TE1100X",
"taxonomy_group": "",
"desc": "Psychologist, Exercise & Sports",
"state": "CA",
"license": "PSY 17422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.