Individual provider Active NPI

Carl H Shubs, PHD

  • Clinical Psychologist
  • Beverly Hills, CA
National Provider Identifier
1720193790
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY8912 Issued in CA
Practice address
321 S Beverly Dr
Suite L
Beverly Hills, CA 90212-4303
Phone
(310) 772-0520
Fax
(323) 654-3032
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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 PSY8912 CA Primary

Addresses

Primary practice location

321 S Beverly Dr
Suite L
Beverly Hills, CA 90212-4303

Mailing address

321 S Beverly Dr
Suite L
Beverly Hills, CA 90212-4303
Phone (310) 772-0520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 10, 2021 through Sep 10, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY8912CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1720193790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S BEVERLY DR",
            "address_2": "SUITE L",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124303",
            "telephone_number": "310-772-0520",
            "fax_number": "323-654-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S BEVERLY DR",
            "address_2": "SUITE L",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124303",
            "telephone_number": "310-772-0520",
            "fax_number": "323-654-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBS",
        "first_name": "CARL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.