Active NPI
Nathaniel Thomas, PH.D
- Clinical Psychologist
- Culver City, CA
National Provider Identifier
1417017377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY17585
- Practice address
- 9696 Culver Blvd Ste 303
Culver City, CA 90232-2759 - Phone
- (323) 971-1405
- Fax
- (213) 487-9658
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY17585 | CA | Primary |
Addresses
Primary practice location
9696 Culver Blvd Ste 303
Culver City, CA 90232-2759
Mailing address
1303 S Rimpau Blvd
Los Angeles, CA 90019-3022
Phone (323) 971-1405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY17585 | CA | MD | Clinical Psychologist |
| 17585 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269388800000",
"number": "1417017377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1303 S RIMPAU BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900193022",
"telephone_number": "323-971-1405",
"fax_number": "213-487-9658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9696 CULVER BLVD STE 303",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902322759",
"telephone_number": "323-971-1405",
"fax_number": "213-487-9658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "NATHANIEL",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2010-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY17585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.