Bethany Vaudrey, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY28607 Issued in CA

Practice address

28328 Agoura Rd Ste 102
Agoura Hills, CA 91301

Phone

(818) 918-0574

NPI assigned

Aug 1, 2012

Last updated

Oct 23, 2019By the provider in NPPES

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

Opted out of Medicare

Yes, effective Oct 24, 2025 through Oct 24, 2027

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sunlight Psychological Services

  • Clinical Child & Adolescent Psychologist
  • Agoura Hills, CA
  • NPI 1811564792
  NPD Authorized official

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1902152507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28328 AGOURA RD STE 102",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012739",
            "telephone_number": "818-918-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28328 AGOURA RD STE 102",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "91301",
            "telephone_number": "818-918-0574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8550 Balboa Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913253579",
            "country_code": "US",
            "telephone_number": "818-739-5612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUDREY",
        "first_name": "BETHANY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Valcarenghi, SLP
• Amy Van Daele
• Vanguard Labs LLC
• Vargo Physical Therapy, Inc
• Lauren Vataniman, PH.D.
• Marilyn Vaughn
• Veecare Hospice Care, Inc.
• Miriam Esther Vendelbosch, DC
• Kianna Verduzco, LMFT
• Vici Performance LLC

• Clinical Psychologist in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.