Erica I Reynoso, PH.D. , LCSW

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

25811 Issued in CA

Practice address

427 Encinal Canyon Rd
Malibu, CA 90265-2404

Phone

(818) 735-2805

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Malibu, CA
  • NPI 1306850169
  NPD

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619308800000",
    "number": "1376617092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10997",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902956997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 ENCINAL CANYON RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652404",
            "telephone_number": "818-735-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "ERICA",
        "middle_name": "I",
        "credential": "PH.D. , LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2021-04-25",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 22233",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "25811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asha Randall
• Gregg Allen Ratinoff
• Recovery Malibu, Inc.
• Bernard Resnick, MD
• Revitalizing Minds Project
• James Kemp Ribe, M.D.
• Jessica Risk, MPT
• Roberta Ritter, M.D.
• Lisa Jo Rodriguez, M.A. , LMFT
• Erika Denise Romero-Gutierrez, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2021; 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.