Individual provider Active NPI

Traci Time, PSYD, LP

  • Clinical Psychologist
  • Burbank, CA
National Provider Identifier
1376879874
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
28747 Issued in CA
Practice address
191 S Buena Vista St Ste 300
Burbank, CA 91505-4556
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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 28747 CA Primary

Addresses

Primary practice location

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556

Mailing address

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556
Phone (925) 282-1778

Other practice location 1

9250 Reseda Blvd
Northridge, CA 91324-3142
Phone (818) 650-2029

Other practice location 2

6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170328001925 CA Practitioner - Clinical Psychologist 8224313556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

191 S Buena Vista St
Suite 300
Burbank, CA 91505-4556
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28747CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Traci Time Psychotherapy Clinical Current Accepting new patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Jun 19, 2024 Accepting new patients

Locations

191 S Buena Vista St
Ste 300
Burbank, CA 91505
Phone (818) 566-9707

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

22900 Ventura Blvd
Ste 260
Woodland Hills, CA 91364
Phone (818) 224-3320

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.tracitime@148377.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1376879874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9250 Reseda Blvd",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913243142",
            "country_code": "US",
            "telephone_number": "818-650-2029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6200 Wilshire Blvd Ste 1410",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900485815",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIME",
        "first_name": "TRACI",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "28747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.