Individual provider Active NPI

Josetta Rose Kovitch, PSY.D.

  • Clinical Psychologist
  • Sherman Oaks, CA
National Provider Identifier
1396520243
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34501 Issued in CA
Practice address
4955 Van Nuys Blvd Ste 301
Sherman Oaks, CA 91403-1815
Phone
(855) 838-8484
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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 PSY34501 CA Primary

Addresses

Primary practice location

4955 Van Nuys Blvd Ste 301
Sherman Oaks, CA 91403-1815

Mailing address

965 Marview Ave
Los Angeles, CA 90012-1238
Phone (213) 447-9636

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
I20231018003042 CA Practitioner - Clinical Psychologist 8628423183 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
Dadoyan Behavioral Medical Group IncGroup PAC ID 8325358054, 9 clinicians

Practice addresses (Care Compare)

5000 Van Nuys Blvd
Suite 202
Sherman Oaks, CA 91403-1717
Phone (818) 461-8911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY34501CAMDClinical Psychologist

Organizations & group practices 1

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": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1396520243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 MARVIEW AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121238",
            "telephone_number": "213-447-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 301",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031815",
            "telephone_number": "855-838-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVITCH",
        "first_name": "JOSETTA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.