Justin M. Weiss, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30191 Issued in CA

Practice address

20969 Ventura Blvd Ste 214
Woodland Hills, CA 91364-6620

Phone

(818) 835-5143

NPI assigned

Aug 27, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 24, 2024 through Sep 24, 2026

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": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1407104292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20969 VENTURA BLVD STE 214",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646620",
            "telephone_number": "818-835-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20969 VENTURA BLVD STE 214",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646620",
            "telephone_number": "818-835-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JUSTIN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Weiser
• Natasha Elize Weiser
• Evan Thomas Weisman, D.C.
• Anna E Weiss, PT
• Janice Sue Weiss, MFT
• Marc D. Weiss, MD
• Rebecca Loren Weiss, B.S., B.A.
• Stacy A. Weiss, MD
• Bonnie Jill Weissman, P.T.A.
• Dina Tiffany Weitz, PHARM.D.

• Clinical Psychologist in Woodland Hills, CA
• Providers in Woodland Hills, 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 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.