Active NPI
Harry James Stark, PH.D.
- Clinical Psychologist
- Woodland Hills, CA
National Provider Identifier
1508899360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 17859
- Practice address
- 20301 Ventura Blvd Ste 309
Woodland Hills, CA 91364-2462 - Phone
- (818) 825-2743
- Fax
- (818) 710-7428
- NPI assigned
- Jul 7, 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 | PSY 17859 | CA | Primary |
Addresses
Primary practice location
20301 Ventura Blvd Ste 309
Woodland Hills, CA 91364-2462
Mailing address
20301 Ventura Blvd
Suite 309
Woodland Hills, CA 91364-2447
Phone (818) 825-2743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090820000541 | CA | Practitioner - Clinical Psychologist | 5395899652 | Practice locations: Woodland Hills, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
20301 Ventura Blvd
Suite 309
Woodland Hills, CA 91364-2462
Phone (818) 825-2743
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17859 | CA | MD | Clinical Psychologist |
| 17859 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565913600000",
"number": "1508899360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20301 VENTURA BLVD",
"address_2": "SUITE 309",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913642447",
"telephone_number": "818-825-2743",
"fax_number": "818-710-7428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20301 VENTURA BLVD STE 309",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913642462",
"telephone_number": "818-825-2743",
"fax_number": "818-710-7428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "HARRY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2019-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 17859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.