Individual provider Active NPI

Allison Lynn Roddy, PSY.D.

  • Clinical Psychologist
  • Huntington Beach, CA
National Provider Identifier
1164120168
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
94026467 Issued in CA
Practice address
21062 Brookhurst St Ste 208
Huntington Beach, CA 92646-7400
Phone
(330) 719-7158
NPI assigned
Feb 20, 2023
Last updated
Feb 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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 94026467 CA Primary

Addresses

Primary practice location

21062 Brookhurst St Ste 208
Huntington Beach, CA 92646-7400

Mailing address

21062 Brookhurst St Ste 208
Huntington Beach, CA 92646-7400
Phone (330) 719-7158

Other names 1

  • Allie Lynn Roddy Other name

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

State licenses

LicenseStateTypeSpecialty
94026467CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1164120168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21062 BROOKHURST ST STE 208",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926467400",
            "telephone_number": "330-719-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21062 BROOKHURST ST STE 208",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926467400",
            "telephone_number": "330-719-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDY",
        "first_name": "ALLISON",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "94026467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLIE",
            "last_name": "RODDY",
            "middle_name": "LYNN",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.