Rebecca Staton, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17177 Issued in CA

Practice address

2730 Wilshire Blvd
Suite 620
Santa Monica, CA 90403-4743

Phone

(310) 453-8737

Fax

(310) 453-3331

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851416101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "SUITE 620",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743",
            "telephone_number": "310-453-8737",
            "fax_number": "310-453-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "SUITE 620",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743",
            "telephone_number": "310-453-8737",
            "fax_number": "310-453-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.