Individual provider Active NPI

Dean Edward Bertsch, PSY.D.

  • Clinical Psychologist
  • South Pasadena, CA
National Provider Identifier
1245360601
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15687 Issued in CA
Practice address
625 Fair Oaks Ave Ste 300
Hathaway-Sycamores Child and Family Services
South Pasadena, CA 91030-5805
Phone
(626) 831-6796
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 PSY15687 CA Primary

Addresses

Primary practice location

625 Fair Oaks Ave Ste 300
Hathaway-Sycamores Child and Family Services
South Pasadena, CA 91030-5805

Mailing address

11840 Chandler Blvd., Apt. 230
Los Angeles, CA 91607
Phone (818) 980-1049

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
PSY15687CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245360601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11840 CHANDLER BLVD., APT. 230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "818-980-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 FAIR OAKS AVE STE 300",
            "address_2": "HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICES",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910305805",
            "telephone_number": "626-831-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCH",
        "first_name": "DEAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.