Active NPI
Richard Steven Tibor, PH.D
- Clinical Psychologist
- Redondo Beach, CA
National Provider Identifier
1326078718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 12809
- Practice address
- 502 Torrance Blvd
Redondo Beach, CA 90277-3413 - Phone
- (310) 316-0811
- Fax
- (310) 540-8932
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 12809 | CA | Primary |
Addresses
Primary practice location
502 Torrance Blvd
Redondo Beach, CA 90277-3413
Mailing address
502 Torrace Blvd.
Redondo Beach, CA 90278
Phone (310) 316-0811
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12809 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY 12809 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326078718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 TORRACE BLVD.",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "90278",
"telephone_number": "310-316-0811",
"fax_number": "310-540-8932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 TORRANCE BLVD",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902773413",
"telephone_number": "310-316-0811",
"fax_number": "310-540-8932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBOR",
"first_name": "RICHARD",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 12809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, 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.