Individual provider Active NPI

Kyle Joseph Decker, BS

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1902509490
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
760 Westwood PLZ Ofc UCLA
Los Angeles, CA 90024-5055
Phone
(310) 825-9989
NPI assigned
Mar 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Psychiatry Physician 2084P0800X 1902509490 CA

Addresses

Primary practice location

760 Westwood PLZ Ofc UCLA
Los Angeles, CA 90024-5055

Mailing address

760 Westwood PLZ Ofc UCLA
Los Angeles, CA 90024-5055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250710001020 CA Order and Referring Only - PsychiatryPractitioner - Psychiatry 6608380621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1902509490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ OFC UCLA",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ OFC UCLA",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "310-825-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "KYLE",
        "middle_name": "JOSEPH",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "1902509490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.