Elizabeth Gustafson, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

3306 Glendale Blvd Ste 7
Los Angeles, CA 90039

Phone

(323) 963-3335

NPI assigned

Apr 22, 2013

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, 2018 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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1871937862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 GLENDALE BLVD STE 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391838",
            "telephone_number": "323-963-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3306 GLENDALE BLVD STE 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90039",
            "telephone_number": "323-963-3335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 N Brand Blvd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912032349",
            "country_code": "US",
            "telephone_number": "323-963-3335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnny Gushiken, DPM
• Elen Gusman
• Enrique Humberto Gusman, SUDRC
• Estefanie Gusman
• Kedra Daisy Guss
• Julie Gustafson
• Gustavo a Alza MD a Medical Corporation
• Mary Jo Gustin, D.C.
• Sarah N Gustin, RD
• Kimberly Ann Gustovich, M.A., CCC-A

• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.