Michelle B Smith PSYD Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 24756 Issued in CA

Legal business name

MICHELLE B SMITH PSYD INC

Practice address

11911 San Vicente Blvd
Suite 270
Los Angeles, CA 90049-5086

Phone

(310) 663-6638

NPI assigned

Apr 23, 2012

Organization subpart

No

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

Authorized official

Name

Michelle S. Bilotta-Smith, PSYD

Title

Owner

Phone

(310) 663-6638

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1629335054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 SAN VICENTE BLVD",
            "address_2": "SUITE 270",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495086",
            "telephone_number": "310-663-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 SAN VICENTE BLVD",
            "address_2": "SUITE 270",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495086",
            "telephone_number": "310-663-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE B SMITH PSYD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "BILOTTA-SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-663-6638",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 24756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.