NPIMap

Organization Active NPI

Culver City Psychological Associates, Inc.

  • Clinical Psychologist
  • Culver City, CA
National Provider Identifier
1689684607
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15514 Issued in CA
Legal business name
CULVER CITY PSYCHOLOGICAL ASSOCIATES, INC.
Practice address
5000 Overland Ave
8
Culver City, CA 90230-4995
Phone
(310) 838-2738
Fax
(310) 838-2729
NPI assigned
Aug 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Valerie Witherspoon, PHD, RN, CNSNPI 1700850278
Title
President
Phone
(310) 838-2738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY13838 CA
Clinical Psychologist 103TC0700X PSY15514 CA Primary

Addresses

Primary practice location

5000 Overland Ave
8
Culver City, CA 90230-4995

Mailing address

PO Box 2900
Culver City, CA 90231-2900
Phone (310) 838-2738

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060307000419 CA Part B Supplier - Clinic/Group Practice 3779590385 Receives reassigned benefits from 1 practitioner
Practice locations: Hermosa Beach, CA

National Provider Directory

National Provider Directory

Locations

5000 Overland Ave
#8
Culver City, CA 90230
Phone (310) 838-2738

5000 Overland Ave
Ste 108
Culver City, CA 90230
Phone (310) 280-9670

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689684607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2900",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902312900",
            "telephone_number": "310-838-2738",
            "fax_number": "310-838-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 OVERLAND AVE",
            "address_2": "8",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304995",
            "telephone_number": "310-838-2738",
            "fax_number": "310-838-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULVER CITY PSYCHOLOGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WITHERSPOON",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-838-2738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, RN, CNS"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13838",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.