Azeb B Bhutia, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY29947 Issued in CA

Practice address

16152 Beach Blvd Ste 131
Huntington Beach, CA 92647-3820

Phone

(213) 713-2113

NPI assigned

Oct 25, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Azeb Bekele Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1386997583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2513",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908012513",
            "telephone_number": "213-713-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16152 BEACH BLVD STE 131",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473820",
            "telephone_number": "213-713-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUTIA",
        "first_name": "AZEB",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY29947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AZEB",
            "last_name": "BEKELE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychologist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.