Individual provider Active NPI

Robert W. Godwin, PH.D.

  • Forensic Psychologist
  • Los Angeles, CA
National Provider Identifier
1578863023
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
PSY12516 Issued in CA
Practice address
1990 S Bundy Dr
Ste 300
Los Angeles, CA 90025-5240
Phone
(310) 836-3235
Fax
(310) 447-0840
NPI assigned
Nov 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X PSY12516 CA Primary

Addresses

Primary practice location

1990 S Bundy Dr
Ste 300
Los Angeles, CA 90025-5240

Mailing address

1990 S Bundy Dr
Ste 300
Los Angeles, CA 90025-5240
Phone (310) 836-3235

Other identifiers 1

IdentifierTypeStateIssuer
PSY12516OtherCAMPN

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12516CAMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1578863023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 S BUNDY DR",
            "address_2": "STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255240",
            "telephone_number": "310-836-3235",
            "fax_number": "310-447-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 S BUNDY DR",
            "address_2": "STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255240",
            "telephone_number": "310-836-3235",
            "fax_number": "310-447-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "ROBERT",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY12516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPN",
            "identifier": "PSY12516",
            "state": "CA"
        }
    ],
    "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 Nov 1, 2010; 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.