Individual provider Active NPI

Austin Grinberg, PHD

  • Clinical Psychologist
  • Chatsworth, CA
National Provider Identifier
1972137404
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY30221 Issued in CA
Practice address
21534 Devonshire St Ste I
Chatsworth, CA 91311-2992
Phone
(818) 208-0611
NPI assigned
Feb 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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 PSY30221 CA Primary

Addresses

Primary practice location

21534 Devonshire St Ste I
Chatsworth, CA 91311-2992

Mailing address

21534 Devonshire St Ste I
Chatsworth, CA 91311-2992
Phone (818) 208-0611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 8, 2025 through May 8, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY30221CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1972137404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21534 DEVONSHIRE ST STE I",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112992",
            "telephone_number": "818-208-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21534 DEVONSHIRE ST STE I",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112992",
            "telephone_number": "818-208-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINBERG",
        "first_name": "AUSTIN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, CA

Sources for this page

Verify at the official NPI Registry.