Individual provider Active NPI

Elizabeth Gong-Guy, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1346464641
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9768 Issued in CA
Practice address
300 Medical Plaza Suite 2200
Los Angeles, CA 90095-0001
Phone
(310) 486-8387
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 PSY9768 CA Primary

Addresses

Primary practice location

300 Medical Plaza Suite 2200
Los Angeles, CA 90095-0001

Mailing address

1819 Mandeville Canyon Rd
Los Angeles, CA 90049-2222
Phone (310) 486-8387

Other practice location 1

221 Westwood Plz
John Wooden Center West
Los Angeles, CA 90095
Phone (310) 825-0768

Other practice location 2

1819 Mandeville Canyon Rd
Los Angeles, CA 90049-2222
Phone (310) 486-8387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY9768CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346464641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 MANDEVILLE CANYON RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900492222",
            "telephone_number": "310-486-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLAZA SUITE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-486-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Westwood Plz",
            "address_2": "John Wooden Center West",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90095",
            "country_code": "US",
            "telephone_number": "310-825-0768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1819 Mandeville Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900492222",
            "country_code": "US",
            "telephone_number": "310-486-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONG-GUY",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.