Individual provider Active NPI

Charles Thomas Zeltzer, PH.D.

  • Clinical Psychologist
  • Ventura, CA
National Provider Identifier
1255400628
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 7864 Issued in CA
Practice address
260 Maple CT
Suite 123
Ventura, CA 93003-3516
Phone
(805) 644-0100
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

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 PSY 7864 CA Primary

Addresses

Primary practice location

260 Maple CT
Suite 123
Ventura, CA 93003-3516

Mailing address

260 Maple CT
Suite 123
Ventura, CA 93003-3516
Phone (805) 644-0100

Other identifiers 1

IdentifierTypeStateIssuer
PSY 7864OtherCAPSYCHOLOGY LICENSE

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
PSY 7864CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255400628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MAPLE CT",
            "address_2": "SUITE 123",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033516",
            "telephone_number": "805-644-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MAPLE CT",
            "address_2": "SUITE 123",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033516",
            "telephone_number": "805-644-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELTZER",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 7864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE",
            "identifier": "PSY 7864",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, 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.