Gary Alan Citron, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY12588 Issued in CA

Practice address

1826 S Elena Ave Ste D
Redondo Beach, CA 90277-5718

Phone

(310) 259-5064

Fax

(714) 529-8570

NPI assigned

Jul 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427088277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2559 RIMCREST RD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214557",
            "telephone_number": "310-259-5064",
            "fax_number": "714-529-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 S ELENA AVE STE D",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775718",
            "telephone_number": "310-259-5064",
            "fax_number": "714-529-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITRON",
        "first_name": "GARY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY125880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Lorraine Ciasulli, FNP-C
• Vanessa Cicchini
• Sara Estefany Cifuentez
• Lisa Ciotto
• Lauren Cipiti, PHARMD
• City of Redondo Beach
• Ann M Clark, O.D.
• Catalina Francesca Betty Clark, LM, CPM
• Heather Marie Dubbert Clark, MA, LMFT
• Nathan Clark, DC

• Clinical Psychologist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.