Individual provider Active NPI

Shivani Bhakta, PSYD.

  • Psychologist
  • Tarzana, CA
National Provider Identifier
1447779087
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
18646 Oxnard St
Tarzana, CA 91356-1411
Phone
(818) 996-1051
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

18646 Oxnard St
Tarzana, CA 91356-1411

Mailing address

12860 East Fwy
Houston, TX 77015-5708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240628002507 TX Practitioner - Clinical Psychologist 7012451248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stonebridge Behavioral Health, P.a.Group PAC ID 3274563929, 3 clinicians

Practice addresses (Care Compare)

1010 Central Pkwy S
San Antonio, TX 78232-5021
Phone (210) 314-3476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stonebridge Behavioral Health, P.a. CurrentSince Jun 20, 2024 Accepting new patients

Locations

3305 81st St
Ste H
Lubbock, TX 79423
Phone (806) 748-6400

1010 Central Pkwy S
San Antonio, TX 78232
Phone (210) 255-1499

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1447779087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12860 EAST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770155708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18646 OXNARD ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561411",
            "telephone_number": "818-996-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "SHIVANI",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.