Jacob Stein, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

32673 Issued in CA

Practice address

11401 Bloomfield Ave
Norwalk, CA 90650-2015

Phone

(562) 584-8834

NPI assigned

Jul 5, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508218355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 BLOOMFIELD AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906502015",
            "telephone_number": "562-584-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 BLOOMFIELD AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906502015",
            "telephone_number": "562-584-8834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 S Sunwest Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083248",
            "country_code": "US",
            "telephone_number": "909-252-4010",
            "fax_number": "909-252-4055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1355 S Hill St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153012",
            "country_code": "US",
            "telephone_number": "323-644-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEIN",
        "first_name": "JACOB",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "32673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Norwalk, CA
• Providers in Norwalk, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.