Individual provider Active NPI

Zachary M Callas

  • School Psychologist
  • Los Angeles, CA
National Provider Identifier
1568773968
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
535 S Curson Ave # 49MB
Los Angeles, CA 90036-5252
Phone
(530) 913-8031
NPI assigned
Jun 30, 2010
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
School Psychologist 103TS0200X CA Primary

Addresses

Primary practice location

535 S Curson Ave # 49MB
Los Angeles, CA 90036-5252

Mailing address

535 S Curson Ave # 49MB
Los Angeles, CA 90036-5252
Phone (530) 913-8031

Other practice location 1

714 W Main St
Grass Valley, CA 95945-6410
Phone (530) 477-9800

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1568773968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 S CURSON AVE # 49MB",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365252",
            "telephone_number": "530-913-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S CURSON AVE # 49MB",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365252",
            "telephone_number": "530-913-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 W Main St",
            "address_purpose": "LOCATION",
            "city": "Grass Valley",
            "state": "CA",
            "postal_code": "959456410",
            "country_code": "US",
            "telephone_number": "530-477-9800",
            "fax_number": "530-477-9803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAS",
        "first_name": "ZACHARY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": null,
            "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 Jun 27, 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.