Active NPI
Dale Hiebert, PSYD
- Clinical Psychologist
- Torrance, CA
National Provider Identifier
1174227524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY34595
- Practice address
- 2601 Airport Dr Ste 135
Torrance, CA 90505-6141 - Phone
- (424) 424-1600
- Fax
- (424) 201-1601
- NPI assigned
- Mar 29, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PSB94027066 | CA | |
| Clinical Psychologist | 103TC0700X | PSY34595 | CA | Primary |
Addresses
Primary practice location
2601 Airport Dr Ste 135
Torrance, CA 90505-6141
Mailing address
2601 Airport Dr Ste 135
Torrance, CA 90505-6141
Phone (424) 424-1600
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY34595 | CA | MD | Clinical Psychologist |
| 34595 | CA | MD | Clinical Social Worker |
| PSB94027066 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1174227524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 AIRPORT DR STE 135",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905056141",
"telephone_number": "424-424-1600",
"fax_number": "424-201-1601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 AIRPORT DR STE 135",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905056141",
"telephone_number": "424-424-1600",
"fax_number": "424-201-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIEBERT",
"first_name": "DALE",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-29",
"last_updated": "2023-10-16",
"certification_date": "2023-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "PSB94027066",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY34595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.