Individual provider Active NPI

Edward John Giaquinto Jr., PH.D.

  • Clinical Psychologist
  • Woodland Hills, CA
National Provider Identifier
1992756977
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16707 Issued in CA
Practice address
22900 Ventura Blvd Ste 125
Woodland Hills, CA 91364-1283
Phone
(818) 618-8830
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 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 PSY16707 CA Primary

Addresses

Primary practice location

22900 Ventura Blvd Ste 125
Woodland Hills, CA 91364-1283

Mailing address

9909 Topanga Canyon Blvd # 176
Chatsworth, CA 91311-3602
Phone (818) 618-8830

Other practice location 1

342 W San Ysidro Blvd
Suite F
San Ysidro, CA 92173-2495
Phone (619) 662-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2019 through Jan 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY16707CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Giaquinto, PH.D., Inc CurrentSince Nov 24, 2024 Accepting new patients
Healthcare Providers of California Medical Group, Inc Past Accepting new patients
Healthcare Providers of California Medical Group, Inc Past Accepting new patients

Locations

22900 Ventura Blvd
Ste 125
Woodland Hills, CA 91364
Phone (818) 618-8830

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1992756977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 TOPANGA CANYON BLVD # 176",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913113602",
            "telephone_number": "818-618-8830",
            "fax_number": "818-626-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22900 VENTURA BLVD STE 125",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641283",
            "telephone_number": "818-618-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "342 W San Ysidro Blvd",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "San Ysidro",
            "state": "CA",
            "postal_code": "921732495",
            "country_code": "US",
            "telephone_number": "619-662-3880",
            "fax_number": "619-662-2942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIAQUINTO",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.