Organization Active NPI

Michelle Conover PHD a Psychological Corporation

  • Clinical Neuropsychologist
  • Woodland Hills, CA
National Provider Identifier
1740558253
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY21871 Issued in CA
Legal business name
MICHELLE CONOVER PHD A PSYCHOLOGICAL CORPORATION
Practice address
5950 Canoga Ave Ste 100
Woodland Hills, CA 91367-5052
Phone
(818) 340-7700
Fax
(818) 340-7701
NPI assigned
Dec 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Dr. Michelle Conover, PH.D.NPI 1619126125
Title
Chief Executive Officer
Phone
(818) 340-7700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103G00000X PSY21871 CA Primary

Addresses

Primary practice location

5950 Canoga Ave Ste 100
Woodland Hills, CA 91367-5052

Mailing address

5950 Canoga Ave Ste 100
Woodland Hills, CA 91367-5052
Phone (818) 340-7700

Other names 1

  • Southern California Neuropsychology Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231214002318 CA Part B Supplier - Clinic/Group Practice 7618343443 Receives reassigned benefits from 1 practitioner
Practice locations: Woodland Hills, CA

National Provider Directory

National Provider Directory

Locations

21031 Ventura Blvd
Ste 704
Woodland Hills, CA 91364
Phone (818) 340-7700

5950 Canoga Ave
Ste 100
Woodland Hills, CA 91367
Phone (818) 340-7700

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1740558253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 CANOGA AVE STE 100",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913675052",
            "telephone_number": "818-340-7700",
            "fax_number": "818-340-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 CANOGA AVE STE 100",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913675052",
            "telephone_number": "818-340-7700",
            "fax_number": "818-340-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE CONOVER PHD A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "CONOVER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "818-340-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY21871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern California Neuropsychology Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern California Neuropsychology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.