Victoria Grace Carlson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY33537 Issued in CA

Practice address

3306 Glendale Blvd Ste 3
Los Angeles, CA 90039-1838

Phone

(708) 767-7796

NPI assigned

Aug 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Grace Carlson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 11, 2023 through Jul 11, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1417560673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 GLENDALE BLVD STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391838",
            "telephone_number": "708-767-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3306 GLENDALE BLVD STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391838",
            "telephone_number": "708-767-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "VICTORIA",
        "middle_name": "GRACE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-27",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33537",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94025549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "CARLSON",
            "credential": "PSYD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kimberly Helen Carlson, MA, MFT
• Margrit Ellen Carlson, MD
• Matthew Todd Carlson, LPCC
• Monique Carlson
• Phoebe Carlson
• Carlston Dental Group
• Dean L Carlston, DDS
• Fredrick A Carlston, NP
• Julaine Carlstrom, MFT
• Carol A Carlton

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.