Individual provider Active NPI

Robert Stanley Horowitz, PH.D.

  • Clinical Psychologist
  • Bend, OR
National Provider Identifier
1194766337
Registry record updated Oct 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
#1764 Issued in OR
Practice address
777 NW Wall St
#305
Bend, OR 97701-2731
Phone
(541) 598-5850
Fax
(541) 389-9095
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2007

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 #1764 OR Primary

Addresses

Primary practice location

777 NW Wall St
#305
Bend, OR 97701-2731

Mailing address

777 NW Wall St
#305
Bend, OR 97701-2731
Phone (541) 598-5850

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
#1764ORMDClinical Psychologist
1764ORMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193529600000",
    "number": "1194766337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 NW WALL ST",
            "address_2": "#305",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977012731",
            "telephone_number": "541-598-5850",
            "fax_number": "541-389-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 NW WALL ST",
            "address_2": "#305",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977012731",
            "telephone_number": "541-598-5850",
            "fax_number": "541-389-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOROWITZ",
        "first_name": "ROBERT",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "#1764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2007; 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.