Theodore Otvos, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY17939 Issued in CA

Practice address

4201 Long Beach Blvd
Ste.230
Long Beach, CA 90807-2007

Phone

(562) 988-1000

Fax

(562) 426-5211

NPI assigned

Oct 6, 2006

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Resources Psychological Group

  • Group Psychotherapy Psychologist
  • Long Beach, CA
  • NPI 1679665939
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609963933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LONG BEACH BLVD",
            "address_2": "STE.230",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072007",
            "telephone_number": "562-988-1000",
            "fax_number": "562-426-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LONG BEACH BLVD",
            "address_2": "STE.230",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072007",
            "telephone_number": "562-988-1000",
            "fax_number": "562-426-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTVOS",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY17939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayat Othman
• Gloria Otieno-Obilo, NP
• Folasade Otti
• Emily Ottiniano, D.O.
• Jean Otto, PH.D.
• Kathleen Ouchi, RN, PHN
• Alice Nicole Oueijan
• Amanda Karen Ouellette Williams
• Mona Sotharath Oul
• Davisna Oum

• Psychologist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.