Individual provider Active NPI

Paul A Boyle, PH.D.

  • Clinical Psychologist
  • Santa Monica, CA
National Provider Identifier
1962455246
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY09193 Issued in CA
Practice address
1137 2ND St
Suite 207
Santa Monica, CA 90403-5011
Phone
(310) 394-2586
Fax
(310) 895-7644
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY09193 CA Primary
Marriage & Family Therapist 106H00000X MFC 13759 CA

Addresses

Primary practice location

1137 2ND St
Suite 207
Santa Monica, CA 90403-5011

Mailing address

847 5TH St
Suite 103
Santa Monica, CA 90403-1351
Phone (310) 394-2586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY09193CAMDClinical Psychologist
MFC 13759CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1962455246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 5TH ST",
            "address_2": "SUITE 103",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031351",
            "telephone_number": "310-394-2586",
            "fax_number": "310-895-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 2ND ST",
            "address_2": "SUITE 207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035011",
            "telephone_number": "310-394-2586",
            "fax_number": "310-895-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY09193",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 13759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.