Active NPI
Pamela Kebrdle, PHD
- Prescribing (Medical) Psychologist
- Hollywood, FL
National Provider Identifier
1982817359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- PY0005077
- Practice address
- 3475 Sheridan St
#308
Hollywood, FL 33021-3663 - Phone
- (954) 964-3040
- Fax
- (954) 964-2496
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | PY0005077 | FL | Primary |
Addresses
Primary practice location
3475 Sheridan St
#308
Hollywood, FL 33021-3663
Mailing address
3475 Sheridan St
#308
Hollywood, FL 33021-3663
Phone (954) 964-3040
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY0005077 | FL | MD | Prescribing (Medical) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982817359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3475 SHERIDAN ST",
"address_2": "#308",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213663",
"telephone_number": "954-964-3040",
"fax_number": "954-964-2496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3475 SHERIDAN ST",
"address_2": "#308",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213663",
"telephone_number": "954-964-3040",
"fax_number": "954-964-2496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEBRDLE",
"first_name": "PAMELA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "FL",
"license": "PY0005077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.