Individual provider Active NPI

David Cimbora, PH.D.

  • Clinical Psychologist
  • La Mirada, CA
National Provider Identifier
1619180692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
16114 Issued in CA
Practice address
12625 La Mirada Blvd Ste 202
Biola Counseling Center
La Mirada, CA 90638-2213
Phone
(562) 903-4800
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 16114 CA Primary

Addresses

Primary practice location

12625 La Mirada Blvd Ste 202
Biola Counseling Center
La Mirada, CA 90638-2213

Mailing address

13800 Biola Ave
Rosemead School of Psychology
La Mirada, CA 90639-0001
Phone (562) 903-4867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2017 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
16114CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Biola Counseling Center Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619180692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 BIOLA AVE",
            "address_2": "ROSEMEAD SCHOOL OF PSYCHOLOGY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906390001",
            "telephone_number": "562-903-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 LA MIRADA BLVD STE 202",
            "address_2": "BIOLA COUNSELING CENTER",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382213",
            "telephone_number": "562-903-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMBORA",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "16114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.