Active NPI
Seth Goradietsky
- Psychologist
- Calabasas, CA
National Provider Identifier
1811221542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY26273
- Practice address
- 22231 Mulholland Hwy
Suite 106
Calabasas, CA 91302-5123 - Phone
- (818) 222-9300
- Fax
- (818) 223-8224
- NPI assigned
- Sep 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY26273 | CA | |
| Psychologist | 103T00000X | PSY26273 | CA | Primary |
Addresses
Primary practice location
22231 Mulholland Hwy
Suite 106
Calabasas, CA 91302-5123
Mailing address
1400 N Hayworth Ave
Apt. 8
West Hollywood, CA 90046-3858
Phone (503) 481-5250
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230303001511 | CA | Practitioner - Clinical Psychologist | 1355714866 | Practice locations: Pasadena, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY26273 | CA | MD | Clinical Psychologist |
| 26273 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417132800000",
"number": "1811221542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 N HAYWORTH AVE",
"address_2": "APT. 8",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900463858",
"telephone_number": "503-481-5250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22231 MULHOLLAND HWY",
"address_2": "SUITE 106",
"city": "CALABASAS",
"state": "CA",
"postal_code": "913025123",
"telephone_number": "818-222-9300",
"fax_number": "818-223-8224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORADIETSKY",
"first_name": "SETH",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-29",
"last_updated": "2014-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY26273",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY26273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calabasas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.