Individual provider Active NPI

Debra Greenberg, PH.D.

  • Psychologist
  • Burbank, CA
National Provider Identifier
1245396571
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY9641 Issued in CA
Practice address
4444 W Riverside Dr
Suite 205
Burbank, CA 91505-4073
Phone
(818) 566-3530
Fax
(818) 845-1615
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY9641 CA Primary

Addresses

Primary practice location

4444 W Riverside Dr
Suite 205
Burbank, CA 91505-4073

Mailing address

4444 W Riverside Dr
Suite 205
Burbank, CA 91505-4073
Phone (818) 566-3530

Other identifiers 3

IdentifierTypeStateIssuer
PSY9641OtherCABLUE CROSS OF CALIFORNIA
680000015OtherGARAILROAD MEDICARE
PSY096410MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080311000354 CA Practitioner - Clinical Psychologist 8820173198 Practice locations: Burbank, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4444 W Riverside Dr
Suite 205
Burbank, CA 91505-4048
Phone (818) 566-3530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY9641CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1245396571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W RIVERSIDE DR",
            "address_2": "SUITE 205",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054073",
            "telephone_number": "818-566-3530",
            "fax_number": "818-845-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W RIVERSIDE DR",
            "address_2": "SUITE 205",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054073",
            "telephone_number": "818-566-3530",
            "fax_number": "818-845-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "DEBRA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CALIFORNIA",
            "identifier": "PSY9641",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "680000015",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY096410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.