Individual provider Active NPI

Bruce Lee Whitney, PH.D.

  • Clinical Psychologist
  • Westlake Village, CA
National Provider Identifier
1790764389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14884 Issued in CA
Practice address
2239 Townsgate Rd
Suite 104
Westlake Village, CA 91361-2405
Phone
(805) 493-0325
Fax
(805) 241-3552
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY14884 CA Primary

Addresses

Primary practice location

2239 Townsgate Rd
Suite 104
Westlake Village, CA 91361-2405

Mailing address

2239 Townsgate Rd
Suite 104
Westlake Village, CA 91361-2405
Phone (805) 493-0325

Other identifiers 1

IdentifierTypeStateIssuer
PSY14884OtherCASTATE LICENSE

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
I20040506000496 CA Practitioner - Clinical Psychologist 5698763951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2393 Townsgate Rd
Suite 100a
Westlake Village, CA 91361-2513
Phone (805) 496-2343

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14884CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce L. Whitney, PH.D., a Pscyhology Corporation Clinical CurrentSince Jan 1, 2004 Accepting new patients

Locations

2393 Townsgate Rd
Ste 100A
Westlake Vlg, CA 91361
Phone (805) 496-2343

2239 Townsgate Rd
Ste 104
Westlake Vlg, CA 91361
Phone (805) 493-0325

Organizations & group practices 1

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790764389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 TOWNSGATE RD",
            "address_2": "SUITE 104",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612405",
            "telephone_number": "805-493-0325",
            "fax_number": "805-241-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 TOWNSGATE RD",
            "address_2": "SUITE 104",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612405",
            "telephone_number": "805-493-0325",
            "fax_number": "805-241-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "BRUCE",
        "middle_name": "LEE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PSY14884",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.