Gretchen Kubacky, Psy.D., Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY21917 Issued in CA

Legal business name

GRETCHEN KUBACKY, PSY.D., INC.

Practice address

10883 Arizona Avenue
Culver City, CA 90232

Phone

(310) 625-6083

NPI assigned

Aug 7, 2012

Last updated

Nov 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gretchen Kubacky, PSY.D.NPI 1740408871

Title

Owner/President

Phone

(310) 625-6083

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gretchen Kubacky, PSY.D.

  • Psychologist
  • Culver City, CA
  • NPI 1740408871
  Authorized official Same address or phone

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1780931949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10883 ARIZONA AVENUE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90232",
            "telephone_number": "310-625-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10883 ARIZONA AVENUE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90232",
            "telephone_number": "310-625-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRETCHEN KUBACKY, PSY.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "KUBACKY",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "310-625-6083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Green
• Lyric-Monick Sharon-Marie Green
• Roshunn Latrice Green
• Alyssa Greer
• Anna R. Grellert
• Chloe Grey
• Dominique Griffin, NP
• Gayane Grigoryan
• Lisa Karen Grimes, PH.D.
• Tiffany Shantel Grimes, PHD

• Psychologist in Culver City, CA
• Providers in Culver City, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.