Active NPI
Timothy J. Beyer, PH.D., L.P.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1679644926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23622
- Practice address
- 300 UCLA Medical PLZ Ste 2200
Los Angeles, CA 90095-4527 - Phone
- (310) 825-9989
- NPI assigned
- Nov 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 23622 | CA | |
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 23622 | CA | |
| Clinical Psychologist | 103TC0700X | 23622 | CA | Primary |
Addresses
Primary practice location
300 UCLA Medical PLZ Ste 2200
Los Angeles, CA 90095-4527
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55G16BE | Other | MN | BLUE CROSS BLUE SHIELD |
| 056672100 | Other | MN | MEDICAL ASSISTANCE |
| 55G17BE | Other | MN | BLUE CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23622 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1679644926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 UCLA MEDICAL PLZ STE 2200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900954527",
"telephone_number": "310-825-9989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEYER",
"first_name": "TIMOTHY",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PH.D., L.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-10",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "23622",
"primary": false
},
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "CA",
"license": "23622",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "23622",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "55G16BE",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "056672100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "55G17BE",
"state": "MN"
}
],
"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 Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.