Active NPI
Anne Victoria Tootell, PHD
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1770140352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34157
- Practice address
- 11900 W Olympic Blvd Ste 410
Los Angeles, CA 90064-1168 - Phone
- (310) 243-6479
- NPI assigned
- May 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 34157 | CA | Primary |
Addresses
Primary practice location
11900 W Olympic Blvd Ste 410
Los Angeles, CA 90064-1168
Mailing address
11900 W Olympic Blvd Ste 410
Los Angeles, CA 90064-1168
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34157 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1770140352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11900 W OLYMPIC BLVD STE 410",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11900 W OLYMPIC BLVD STE 410",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641168",
"telephone_number": "310-243-6479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOOTELL",
"first_name": "ANNE",
"middle_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-20",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "34157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.