Derek Todd Schwartz, PH.D, BCIAC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY22176 Issued in CA

Practice address

8813 Villa la Jolla Dr
Ste. 2002
La Jolla, CA 92037-1937

Phone

(858) 877-0770

Fax

(858) 452-1517

NPI assigned

Sep 12, 2008

Last updated

Jan 5, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1760631899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8813 VILLA LA JOLLA DR",
            "address_2": "STE. 2002",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371937",
            "telephone_number": "858-877-0770",
            "fax_number": "858-452-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8813 VILLA LA JOLLA DR",
            "address_2": "STE. 2002",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371937",
            "telephone_number": "858-877-0770",
            "fax_number": "858-452-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "DEREK",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "PH.D, BCIAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-12",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Schulz
• Abbigale A Schumsky
• Chet Schwab
• Richard Bruce Schwab, M.D.
• Ben Liad Schwartz, MD, MBA
• Janet Ruth Schwartz, M.D.
• Rachel Lynn Schwartzman, LCSW
• James G. Schwendig, M.D.
• Angela Lynn Scioscia, M.D.
• Scott David Simon MD Facs Medical Corporation

• Psychologist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.