NPIMap

Organization Active NPI

UCLA Psychology Clinic

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1518000355
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 6144 Issued in CA
Legal business name
UCLA PSYCHOLOGY CLINIC
Practice address
UCLA Psychology Clinic
2191 Franz Hall Box 951563
Los Angeles, CA 90095-1563
Phone
(310) 825-2305
Fax
(310) 825-2306
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jill Waterman, PH.D.
Title
Clinic Coordinator
Phone
(310) 825-2305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY 6144 CA Primary

Addresses

Primary practice location

UCLA Psychology Clinic
2191 Franz Hall Box 951563
Los Angeles, CA 90095-1563

Mailing address

UCLA Psychology Clinic
2191 Franz Hall Box 951563
Los Angeles, CA 90095-1563
Phone (310) 825-2305

National Provider Directory

National Provider Directory
Tax ID family
Regents of the Univ of Ca56 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

Ucla Psychology Clinic
Los Angeles, CA 90095
Phone (310) 825-2305

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518000355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCLA PSYCHOLOGY CLINIC",
            "address_2": "2191 FRANZ HALL BOX 951563",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951563",
            "telephone_number": "310-825-2305",
            "fax_number": "310-825-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA PSYCHOLOGY CLINIC",
            "address_2": "2191 FRANZ HALL BOX 951563",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951563",
            "telephone_number": "310-825-2305",
            "fax_number": "310-825-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCLA PSYCHOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "CLINIC COORDINATOR",
        "authorized_official_telephone_number": "310-825-2305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 6144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.