Active NPI
Wayne A. Taubenfeld, PH.D.
- Clinical Psychologist
- Glendale, CA
National Provider Identifier
1497795173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY18267
- Practice address
- 1317 N Brand Blvd Apt 7
Glendale, CA 91202-1969 - Phone
- (310) 529-8293
- NPI assigned
- Jun 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18267 | CA | Primary |
Addresses
Primary practice location
1317 N Brand Blvd Apt 7
Glendale, CA 91202-1969
Mailing address
3094 Summit Terrace Dr
Eugene, OR 97405-6254
Phone (541) 285-1044
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1874 | OR | MD | Family Medicine Physician |
| 18267 | CA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430092800000",
"number": "1497795173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3094 SUMMIT TERRACE DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974056254",
"telephone_number": "541-285-1044",
"fax_number": "541-485-7190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 N BRAND BLVD APT 7",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912021969",
"telephone_number": "310-529-8293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAUBENFELD",
"first_name": "WAYNE",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2015-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.