Active NPI
Scott Owen Harris, PH.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1427209949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY8805
- Practice address
- 11980 San Vicente Blvd.
Suite 710
Los Angeles, CA 90049 - Phone
- (310) 422-7468
- Fax
- (310) 476-4160
- NPI assigned
- Oct 2, 2008
- Last updated
- Apr 27, 2021
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | ||
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | NU | ||
| Clinical Psychologist | 103TC0700X | PSY8805 | CA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | NU |
Addresses
Primary practice location
11980 San Vicente Blvd.
Suite 710
Los Angeles, CA 90049
Mailing address
11980 San Vicente Blvd.
Suite 710
Los Angeles, CA 90049
Phone (310) 422-7468
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 25, 2024 through Apr 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8805 | CA | MD | Professional Counselor |
| PSY8805 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619481600000",
"number": "1427209949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11980 SAN VICENTE BLVD.",
"address_2": "SUITE 710",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90049",
"telephone_number": "310-422-7468",
"fax_number": "310-476-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11980 SAN VICENTE BLVD.",
"address_2": "SUITE 710",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90049",
"telephone_number": "310-422-7468",
"fax_number": "310-476-4160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "SCOTT",
"middle_name": "OWEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-02",
"last_updated": "2021-04-27",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY8805",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.