Active NPI
Carol Rotko, PSYD
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1487182234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23788
- Practice address
- 2820 Glendale Blvd # 5
Los Angeles, CA 90039-2723 - Phone
- (323) 422-1600
- NPI assigned
- May 24, 2017
- Sex
- Female
- 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 | 23788 | CA | Primary |
Addresses
Primary practice location
2820 Glendale Blvd # 5
Los Angeles, CA 90039-2723
Mailing address
2820 Glendale Blvd # 5
Los Angeles, CA 90039-2723
Phone (323) 422-1600
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23788 | CA | MD | Addiction Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495584000000",
"number": "1487182234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 GLENDALE BLVD # 5",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900392723",
"telephone_number": "323-422-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 GLENDALE BLVD # 5",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900392723",
"telephone_number": "323-422-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTKO",
"first_name": "CAROL",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-24",
"last_updated": "2017-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "23788",
"primary": true
}
],
"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 May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.