Individual provider Active NPI

Nancy Stancil, PHD

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1760840672
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
28715 Issued in CA
Practice address
11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814
Phone
(310) 273-4843
Fax
(310) 273-5056
NPI assigned
Feb 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 10273 MA
Psychologist 103T00000X 28715 CA Primary

Addresses

Primary practice location

11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814

Mailing address

11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814
Phone (310) 273-4843

Other practice location 1

26137 La Paz Rd Ste 230
Mission Viejo, CA 92691-5337
Phone (217) 637-8858

Other practice location 2

11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814
Phone (310) 273-4843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190307000975 CA Practitioner - Clinical Psychologist 0547509614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Executive Mental Health, IncGroup PAC ID 0345209102, 47 clinicians

Practice addresses (Care Compare)

11835 W Olympic Blvd
Suite 1270E
Los Angeles, CA 90064-5053
Phone (310) 273-4843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
28715CAMDPsychologist
10273MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Wu MD PHD Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

16890 Green Tree Blvd
Victorville, CA 92395
Phone (310) 273-4843

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1760840672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 1265E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645814",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 1265E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645814",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26137 La Paz Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926915337",
            "country_code": "US",
            "telephone_number": "217-637-8858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11835 W Olympic Blvd Ste 1265E",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900645814",
            "country_code": "US",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANCIL",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-05",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "10273",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "28715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.