Active NPI
Stephen Anthony Ambrose, PH.D.
- Psychologist
- Los Angeles, CA
National Provider Identifier
1720105802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY8968
- Practice address
- 711 S New Hampshire Ave
Los Angeles, CA 90005-1831 - Phone
- (213) 385-5100
- Fax
- (213) 383-1820
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY8968 | CA | Primary |
Addresses
Primary practice location
711 S New Hampshire Ave
Los Angeles, CA 90005-1831
Mailing address
2927 Rolling Ridge Dr
Burbank, CA 91504-1638
Phone (213) 385-5100
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8968 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720105802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2927 ROLLING RIDGE DR",
"city": "BURBANK",
"state": "CA",
"postal_code": "915041638",
"telephone_number": "213-385-5100",
"fax_number": "213-383-1820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 S NEW HAMPSHIRE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900051831",
"telephone_number": "213-385-5100",
"fax_number": "213-383-1820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROSE",
"first_name": "STEPHEN",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY8968",
"primary": true
}
],
"identifiers": [],
"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 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.