Charles Josh Scrantom, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY31186 Issued in CA

Practice address

11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064-5814

Phone

(310) 273-4843

Fax

(310) 273-5056

NPI assigned

Aug 22, 2014

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Brian Wu MD PHD Inc

  • Psychiatry Physician
  • San Gabriel, CA
  • NPI 1528639481
  NPD

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1891194189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 DANBURY LN",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 1265E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645814",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 N Avalon Blvd",
            "address_2": "Wilmington Clinic",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "CA",
            "postal_code": "907442639",
            "country_code": "US",
            "telephone_number": "310-513-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCRANTOM",
        "first_name": "CHARLES",
        "middle_name": "JOSH",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trezionna Zi'Ar Scott I
• Yvette Godwin Scott, DO
• Zoe Scott
• Mary Ellen Scotti, N.P.
• Thomas Carter Scotton, M.D.
• Marcie Scranton, MFT
• Antonia Maria Erika Scremin, MD
• Tristan Scremin
• Gina Scrimo
• Scripps Clinic Medical Group

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.