Individual provider Active NPI

Bobbie Renae Harris

  • Clinical Child & Adolescent Psychologist
  • Woodland Hills, CA
National Provider Identifier
1750867156
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1111111 Issued in NE
Practice address
21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone
(818) 345-2345
Fax
(818) 758-8015
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 1111111 NE Primary

Addresses

Primary practice location

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807

Mailing address

4022 Newport Ave
Omaha, NE 68112-2959
Phone (402) 779-9764

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

State licenses

LicenseStateTypeSpecialty
1111111NEMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1750867156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 NEWPORT AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681122959",
            "telephone_number": "402-779-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677807",
            "telephone_number": "818-345-2345",
            "fax_number": "818-758-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BOBBIE",
        "middle_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NE",
            "license": "1111111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.