Nancy A Blum, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14122 Issued in CA

Practice address

15915 Ventura Blvd Ste 202
Encino, CA 91436-4433

Phone

(818) 996-7579

Fax

(818) 671-3502

NPI assigned

Jun 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1265438451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15915 VENTURA BLVD STE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364433",
            "telephone_number": "818-996-7579",
            "fax_number": "818-671-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15915 VENTURA BLVD STE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364433",
            "telephone_number": "818-996-7579",
            "fax_number": "818-671-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "NANCY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY14122",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE #",
            "identifier": "PSY14122",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY141220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl I Blau, M.D.
• Jonathan Michael Blau, M.D.
• Nazanin Blitshteyn, RDN
• Blue Sky Mental Health Inc
• Blueberry Medical (Sleepytime)
• Avrum Z Bluming, MD
• Donald Blumkin, PHARM D
• Sulangi Bluntt, MS CCC-SLP
• Blythe Project LLC
• Lauren Renee Boasberg, LMFT

• Clinical Psychologist in Encino, CA
• Providers in Encino, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.