Individual provider Active NPI

Patricia A Zomber, PH.D.

  • Clinical Psychologist
  • Marina del Rey, CA
National Provider Identifier
1659417970
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9176 Issued in CA
Practice address
4640 Admiralty Way
Suite 318
Marina del Rey, CA 90292-6621
Phone
(310) 822-0109
Fax
(310) 822-1240
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

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 PSY9176 CA Primary

Addresses

Primary practice location

4640 Admiralty Way
Suite 318
Marina del Rey, CA 90292-6621

Mailing address

4640 Admiralty Way
Suite 318
Marina del Rey, CA 90292-6621
Phone (310) 822-0109

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Marina Psychological Services 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659417970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY",
            "address_2": "SUITE 318",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926621",
            "telephone_number": "310-822-0109",
            "fax_number": "310-822-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY",
            "address_2": "SUITE 318",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926621",
            "telephone_number": "310-822-0109",
            "fax_number": "310-822-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOMBER",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.