Justin Underwood, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30190 Issued in CA

Practice address

3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533

Phone

(615) 512-9660

NPI assigned

Sep 3, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555804800000",
    "number": "1669806162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E OLIVE AVE",
            "address_2": "STE 540",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012132",
            "telephone_number": "818-446-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102533",
            "telephone_number": "615-512-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2019-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Unaphum
• Uncle Dave'S Housing
• Under Ground Stream Qi Acupuncture
• Kaylee Dawn Underhill, AMFT
• Haley Underwood
• Kathryn Underwood
• Phillip Underwood
• Shane Taylor Underwood
• Undisputed Caregivers
• Michael Undzis

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2019; 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.