Robert Louis Dutile, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY20682 Issued in CA

Practice address

6365 N Constellation Ave
Clovis, CA 93619-6301

Phone

(559) 908-8403

Fax

(888) 518-1501

NPI assigned

Jul 3, 2007

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Male

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

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

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Pacific Coast Psychology Group, Inc.

  • Psychologist
  • Westlake Village, CA
  • NPI 1932647468

  Clinical

  NPD
• Exodus Recovery Inc

  • Community/Behavioral Health Agency
  • Redondo Beach, CA
  • NPI 1437360195
  NPD (past)
• Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1174300412
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1881892511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6365 N CONSTELLATION AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936196301",
            "telephone_number": "559-908-8403",
            "fax_number": "888-518-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6365 N CONSTELLATION AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936196301",
            "telephone_number": "559-908-8403",
            "fax_number": "888-518-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTILE",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyiuche Anthonia Dunu, NP
• Vy H Duong
• David A. Dupuis, LCSW
• Jennifer Duran
• Miguel Andres Duran
• Gabriela Dutra-Clarke
• Jacqueline G. Dy, MD
• Dycora Transitional Health - Clovis LLC
• Dynamic Kids, Inc. (Dynamic Kids Pediatric Physical Therapy)
• Eastwest Pain & Healing Institute LLC

• Clinical Psychologist in Clovis, CA
• Providers in Clovis, 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 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.