Individual provider Active NPI

Steve Kudler, PSY.D, FPPR

  • Clinical Psychologist
  • Canoga Park, CA
National Provider Identifier
1962401919
Registry record updated Jan 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20095 Issued in CA
Practice address
22110 Roscoe Blvd Ste 300
Canoga Park, CA 91304-3837
Phone
(818) 582-6444
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY20095 CA Primary

Addresses

Primary practice location

22110 Roscoe Blvd Ste 300
Canoga Park, CA 91304-3837

Mailing address

PO Box 6393
Woodland Hills, CA 91365-6393
Phone (818) 582-6444

Other identifiers 1

IdentifierTypeStateIssuer
PSY200950MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204003300 AZ Practitioner - Psychologist Billing Independently 9234180357 1 other NPI on this enrollment
Practice locations: Bullhead City, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Bullhead City, AZ 86429
Phone (818) 582-6444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars Assisted Living Past Accepting new patients
David Taftian DO, Inc Past Accepting new patients
Calfornia Care Centers, Inc. PastSince Apr 30, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19088/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1962401919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6393",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913656393",
            "telephone_number": "818-582-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22110 ROSCOE BLVD STE 300",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913043837",
            "telephone_number": "818-582-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLER",
        "first_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "PSY.D, FPPR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY200950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.