Individual provider Active NPI

Sharon Dotemoto, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1841281946
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY12907 Issued in CA
Practice address
1081 Westwood Blvd
Suite 230
Los Angeles, CA 90024-2911
Phone
(310) 208-4487
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
Yes

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
Psychologist 103T00000X PSY12907 CA Primary

Addresses

Primary practice location

1081 Westwood Blvd
Suite 230
Los Angeles, CA 90024-2911

Mailing address

1081 Westwood Blvd
Suite 230
Los Angeles, CA 90024-2911

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
I20090320000331 CA Practitioner - Clinical Psychologist 9234296153 Practice locations: Los Angeles, CA; Hermosa Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1081 Westwood Blvd
Suite 230
Los Angeles, CA 90024-2931
Phone (310) 367-1424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY12907CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841281946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 WESTWOOD BLVD",
            "address_2": "SUITE 230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 WESTWOOD BLVD",
            "address_2": "SUITE 230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242911",
            "telephone_number": "310-208-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTEMOTO",
        "first_name": "SHARON",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.