Individual provider Active NPI

Stephanie J Tarle, PH.D.

  • Clinical Psychologist
  • Oxnard, CA
National Provider Identifier
1659920403
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32155 Issued in CA
Practice address
2200 Outlet Center Dr Ste 470
Oxnard, CA 93036-0611
Phone
(805) 242-8077
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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 PSY32155 CA Primary

Addresses

Primary practice location

2200 Outlet Center Dr Ste 470
Oxnard, CA 93036-0611

Mailing address

2200 Outlet Center Dr Ste 470
Oxnard, CA 93036-0611
Phone (805) 242-8077

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725002076 CA Practitioner - Clinical Psychologist 5294196119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY32155CAMDClinical Psychologist
32155CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Sep 1, 2023 Accepting new patients
Regents of the University of California Clinical CurrentSince Sep 1, 2023 Accepting new patients

Locations

8950 Villa La Jolla Dr
Ste C101
La Jolla, CA 92037
Phone (858) 249-1680

File 57326
Los Angeles, CA 90074

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 2

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": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1659920403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 OUTLET CENTER DR STE 470",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360611",
            "telephone_number": "805-242-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 OUTLET CENTER DR STE 470",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360611",
            "telephone_number": "805-242-8077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARLE",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.