Active NPI
Shari Beth Stillman-Corbitt, PSY.D.
- Clinical Psychologist
- Oak Park, CA
National Provider Identifier
1497035877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 18743
- Practice address
- 28310 Roadside Dr
Suite 222
Oak Park, CA 91301-2669 - Phone
- (310) 848-5418
- NPI assigned
- Aug 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 18743 | CA | |
| Clinical Psychologist | 103TC0700X | 18743 | CA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 18743 | CA |
Addresses
Primary practice location
28310 Roadside Dr
Suite 222
Oak Park, CA 91301-2669
Mailing address
5310 Oak Park LN
Suite 119
Oak Park, CA 91377-5406
Phone (310) 848-5418
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 |
|---|---|---|---|
| 18743 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agoura Neurofeedback | Current | Accepting new patients | |
| Agoura Neurofeedback, Inc. | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Agoura Hills, CA
- NPI 1457694747
-
- Substance Abuse Rehabilitation Facility
- Agoura Hills, CA
- NPI 1083238968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313539200000",
"number": "1497035877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5310 OAK PARK LN",
"address_2": "SUITE 119",
"city": "OAK PARK",
"state": "CA",
"postal_code": "913775406",
"telephone_number": "310-848-5418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28310 ROADSIDE DR",
"address_2": "SUITE 222",
"city": "OAK PARK",
"state": "CA",
"postal_code": "913012669",
"telephone_number": "310-848-5418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILLMAN-CORBITT",
"first_name": "SHARI",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-17",
"last_updated": "2011-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "18743",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "18743",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "18743",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.