Individual provider Active NPI

Carly A Schwartz, PSY.D.

  • Clinical Psychologist
  • Ventura, CA
National Provider Identifier
1821283979
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24683 Issued in CA
Practice address
1001 Partridge Dr Ste 110
Ventura, CA 93003-0714
Phone
(925) 282-1778
NPI assigned
Sep 12, 2007
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 24683 CA
Clinical Psychologist 103TC0700X 24683 CA Primary

Addresses

Primary practice location

1001 Partridge Dr Ste 110
Ventura, CA 93003-0714

Mailing address

1001 Partridge Dr Ste 110
Ventura, CA 93003-0714
Phone (925) 282-1778

Other practice location 1

16800 Devonshire St
Ste 212
Granada Hills, CA 91344-7409
Phone (818) 585-2000

Other names 1

  • Carly A Berdischewsky Former name

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
I20170517001438 CA Practitioner - Clinical Psychologist 7911274261 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24683CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Mar 9, 2025 Accepting new patients
A.M.P. Autism Inc Clinical Past Accepting new patients

Locations

2300 Boswell Rd
Ste 275
Chula Vista, CA 91914
Phone (585) 898-0612

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

1001 Partridge Dr
Ste 110
Ventura, CA 93003

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.carlyschwartz@148377.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1821283979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PARTRIDGE DR STE 110",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930030714",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PARTRIDGE DR STE 110",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930030714",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16800 DEVONSHIRE ST",
            "address_2": "STE 212",
            "address_purpose": "LOCATION",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913447409",
            "country_code": "US",
            "telephone_number": "818-585-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "CARLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "24683",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "BERDISCHEWSKY",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.