Individual provider Active NPI

Stephanie Ellis Katz, PSY.D

  • Clinical Psychologist
  • Van Nuys, CA
National Provider Identifier
1639396302
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28745 Issued in CA
Practice address
7555 Van Nuys Blvd
Cubicle #4N047
Van Nuys, CA 91405-1949
Phone
(818) 904-8807
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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 PSY28745 CA Primary

Addresses

Primary practice location

7555 Van Nuys Blvd
Cubicle #4N047
Van Nuys, CA 91405-1949

Mailing address

7555 Van Nuys Blvd
Cubicle #4N047
Van Nuys, CA 91405-1949
Phone (818) 904-8807

Other names 1

  • Stephanie Ellis Shearer Former name

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

State licenses

LicenseStateTypeSpecialty
PSY28745CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1639396302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 VAN NUYS BLVD",
            "address_2": "CUBICLE #4N047",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051949",
            "telephone_number": "818-904-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 VAN NUYS BLVD",
            "address_2": "CUBICLE #4N047",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051949",
            "telephone_number": "818-904-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "STEPHANIE",
        "middle_name": "ELLIS",
        "name_prefix": "Mrs.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SHEARER",
            "middle_name": "ELLIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.