Individual provider Active NPI

Amanda Spooner, PSY.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1649625815
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25609 Issued in CA
Practice address
1314 Westwood Blvd
Suite 201
Los Angeles, CA 90024-4928
Phone
(323) 207-0539
Fax
(323) 207-0539
NPI assigned
Apr 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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 PSY25609 CA Primary

Addresses

Primary practice location

1314 Westwood Blvd
Suite 201
Los Angeles, CA 90024-4928

Mailing address

1314 Westwood Blvd
Suite 201
Los Angeles, CA 90024-4928
Phone (323) 207-0539

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
PSY25609CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1649625815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 WESTWOOD BLVD",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244928",
            "telephone_number": "323-207-0539",
            "fax_number": "323-207-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 WESTWOOD BLVD",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244928",
            "telephone_number": "323-207-0539",
            "fax_number": "323-207-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOONER",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25609",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 25, 2016; 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.