Active NPI
Aviva Lara Bass-Huh, PSY.D.
- Clinical Psychologist
- Boulder, CO
National Provider Identifier
1497806574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3039
- Practice address
- 6658 Gunpark Dr
Suite 202B
Boulder, CO 80301-3385 - Phone
- (720) 938-3423
- NPI assigned
- Jan 15, 2007
- Last updated
- Apr 7, 2021
- 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 | 3039 | CO | Primary |
Addresses
Primary practice location
6658 Gunpark Dr
Suite 202B
Boulder, CO 80301-3385
Mailing address
6644 Drew Ranch LN
Boulder, CO 80301-3570
Phone (720) 938-3423
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3039 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1497806574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6644 DREW RANCH LN",
"city": "BOULDER",
"state": "CO",
"postal_code": "803013570",
"telephone_number": "720-938-3423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6658 GUNPARK DR",
"address_2": "SUITE 202B",
"city": "BOULDER",
"state": "CO",
"postal_code": "803013385",
"telephone_number": "720-938-3423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASS-HUH",
"first_name": "AVIVA",
"middle_name": "LARA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "3039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
- Baseline Healthcare Inc. (Boulder Canyon Health and Rehabilitation)
- Baseline Healthcare Inc. (Boulder Canyon Health and Rehabilitation)
- Baseline Healthcare, Inc. (Boulder Canyon Health and Rehabilitation)
- Alyssa Audrey Basile
- Kimberly Basler, RDH
- John Todd Bass, DPT
- Elyse Bassman, NLC
- Evelyn J Bassoff, PHD
- Lori J Batcheller, LMT, MPT
- Cheryl Lynn Bates, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.