Active NPI
Dustin Plattner, PSY.D.
- Clinical Psychologist
- Pasadena, CA
National Provider Identifier
1871804005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY-26516
- Practice address
- 482 N Rosemead Blvd
Ste 207
Pasadena, CA 91107-3053 - Phone
- (626) 788-5853
- NPI assigned
- Jun 22, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY-26516 | CA | Primary |
Addresses
Primary practice location
482 N Rosemead Blvd
Ste 207
Pasadena, CA 91107-3053
Mailing address
3579 E Foothill Blvd
# 710
Pasadena, CA 91107-3119
Phone (626) 788-5853
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-26516 | CA | MD | Clinical Psychologist |
| 26516 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478736000000",
"number": "1871804005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3579 E FOOTHILL BLVD",
"address_2": "# 710",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073119",
"telephone_number": "626-788-5853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "482 N ROSEMEAD BLVD",
"address_2": "STE 207",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073053",
"telephone_number": "626-788-5853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLATTNER",
"first_name": "DUSTIN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-22",
"last_updated": "2016-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY-26516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.