Timothy Collister PHD & Associates, Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY12985 Issued in CA

Legal business name

TIMOTHY COLLISTER PHD & ASSOCIATES, INC

Practice address

7024 Seville Ave Ste D
Huntington Park, CA 90255-4969

Phone

(323) 588-9600

NPI assigned

Dec 27, 2006

Last updated

Nov 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy D Collister, PHD

Title

President

Phone

(323) 588-9600

Specialties & licenses 3

Addresses

Other identifiers 2

Tax ID family

Dr Collister and Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Collister and Associates

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Huntington Park, CA
  • NPI 1679648984
  NPD tax ID
• Timothy Collister PHD, Inc.

  • Marriage & Family Therapist
  • Huntington Park, CA
  • NPI 1932224987
  NPD tax ID

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1407912462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 HUNTINGTON DR",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304512",
            "telephone_number": "323-588-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7024 SEVILLE AVE STE D",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554969",
            "telephone_number": "323-588-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY COLLISTER PHD & ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "COLLISTER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-588-9600",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12985",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY12895",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY12895",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY128951",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY12950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vartan L Thomas, DDS
• Bryan Christopher Thompson
• Dion David Thompson, CAADC-DMS
• Kevin Thornburgh
• Thrive Home Health Agency LLC
• Timothy Collister PHD, Inc.
• Top Dental Huntington Park Inc
• Carlo Topalian
• Kristopher Toriz
• Consuelo Torres Gonzalez, SLPA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.