PACIFIC BLUE PSYCHOLOGICAL SERVICES
NPI 1124678719
Psychologist in Sherman Oaks, CA

Active since September 16, 2019
15235 BURBANK BLVD STE A2, SHERMAN OAKS, CA 91411(858) 883-3277 Get Directions Write a Review

NPPES record last updated: October 9, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 9, 2020, Jan 31, 2020, Dec 20, 2019 and 2 more (5 updates tracked since 2019).

About Pacific Blue Psychological Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC BLUE PSYCHOLOGICAL SERVICES (NPI 1124678719) is a healthcare organization registered as a psychologist in Sherman Oaks, California and active in the NPI registry since September 2019. The organization maintains a secondary practice location in Los Angeles and lists John Carroll, Owner, as its authorized official.

NPPES Registry Identity

NPI1124678719
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NamePACIFIC BLUE PSYCHOLOGICAL SERVICES
Location Address15235 BURBANK BLVD STE A2Sherman Oaks, CA 91411-3555
Mailing AddressPo Box 1290Venice, CA 90294-1290
Organization SubpartNo
Authorized OfficialJohn CarrollOwner · (858) 883-3277
Enumeration DateSeptember 16, 2019
Last NPPES UpdateOctober 9, 20205 updates tracked since enumeration
NPPES CertifiedOctober 9, 2020
✔ NPI 1124678719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
15235 BURBANK BLVD STE A2, Sherman Oaks, CA 91411

Secondary Practice Location 1

Location 14133 Redwood Ave Unit 1002Los Angeles, CA 90066-5627 · Phone (858) 883-3277

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pacific Blue Psychological Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

30

Medicare enrollment records show 30 clinicians reassign Medicare billing to Pacific Blue Psychological Services, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 7 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Marriage and Family Therapist13
Clinical Psychologist9
Clinical Social Worker5
Mental Health Counselor3

Nearest to this location (20)

See all 30
Clinical Psychologist
NPI 1972002236
15235 BURBANK BLVD STE A2
Sherman Oaks, CA 91411
(858) 883-3277
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1538704457
15235 BURBANK BLVD STE A2
Sherman Oaks, CA 91411
(310) 591-9696
✔ PECOS✔ Accepts MedicareSame address
Mental Health Counselor
NPI 1497395396
15235 BURBANK BLVD STE A2
Sherman Oaks, CA 91411
(424) 407-1414
✔ PECOS✔ Accepts MedicareSame address
Marriage and Family Therapist
NPI 1679177414
3900 W ALAMEDA AVE
Burbank, CA 91505
(657) 888-3494
✔ PECOS✔ Accepts Medicare7.1 mi
Marriage and Family Therapist
NPI 1992203228
21869 WOODLAND CREST DR
Woodland Hills, CA 91364
(818) 378-5805
✔ PECOS✔ Accepts Medicare8.2 mi
Clinical Social Worker
NPI 1649149527
8500 WILSHIRE BLVD STE 740
Beverly Hills, CA 90211
(516) 282-6429
✔ PECOS✔ Accepts Medicare9.0 mi
Clinical Psychologist
NPI 1669706586
2001 S BARRINGTON AVE STE 314
Los Angeles, CA 90025
(408) 596-0563
✔ PECOS✔ Accepts Medicare9.4 mi
Clinical Social Worker
NPI 1700194768
943 N HOBART BLVD
Los Angeles, CA 90029
(424) 209-9849
✔ PECOS✔ Accepts Medicare11 mi
Mental Health Counselor
NPI 1124790118
12600 BRADDOCK DR APT 118
Los Angeles, CA 90066
(909) 501-4688
✔ PECOS13 mi
Clinical Psychologist
NPI 1942890660
3701 SANTA ROSALIA DR UNIT 1057
Los Angeles, CA 90008
(323) 538-2273
✔ PECOS✔ Accepts Medicare14 mi
Marriage and Family Therapist
NPI 1982369468
990 VILLA STREET, MOUTAIN VIEW, CA
Los Angeles, CA 90043
(888) 688-9296
✔ PECOS✔ Accepts Medicare16 mi
Clinical Psychologist
NPI 1124677695
21545 CENTRE POINTE PKWY
Santa Clarita, CA 91350
(661) 259-9439
✔ PECOS✔ Accepts Medicare17 mi
Marriage and Family Therapist
NPI 1790206209
2418 SAN GABRIEL BLVD STE A
Rosemead, CA 91770
(626) 386-3620
✔ PECOS✔ Accepts Medicare23 mi
Marriage and Family Therapist
NPI 1689185985
108 W VICTORIA ST
Gardena, CA 90248
(310) 715-2020
✔ PECOS✔ Accepts Medicare24 mi
Marriage and Family Therapist
NPI 1831638857
23332 HAWTHORNE BLVD STE 304
Torrance, CA 90505
(213) 302-8259
✔ PECOS✔ Accepts Medicare26 mi
Clinical Social Worker
NPI 1871049817
161 W VICTORIA ST
Long Beach, CA 90805
(323) 381-0837
✔ PECOS✔ Accepts Medicare26 mi
Marriage and Family Therapist
NPI 1902231533
1501 HUGHES WAY SUITE 150
Long Beach, CA 90810
(310) 221-6336
✔ PECOS28 mi
Clinical Psychologist
NPI 1699135558
270 SAN REMO DR
Long Beach, CA 90803
(562) 212-9201
✔ PECOS✔ Accepts Medicare35 mi
Clinical Psychologist
NPI 1962960864
13731 OLIVE STREET
Westminster, CA 92683
(949) 610-6263
✔ PECOS✔ Accepts Medicare39 mi
Mental Health Counselor
NPI 1962801795
308 E SAN JACINTO AVE
Perris, CA 92570
(951) 943-1130
✔ PECOS✔ Accepts Medicare76 mi
See all 30 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Blue Psychological Services's NPI number?

The NPI number for Pacific Blue Psychological Services is 1124678719. It was assigned to this organization in the NPPES registry on September 16, 2019.

Where is Pacific Blue Psychological Services located?

Pacific Blue Psychological Services is located at 15235 Burbank Blvd Ste A2, Sherman Oaks, CA 91411. The listed phone number is (858) 883-3277.

What is Pacific Blue Psychological Services's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Pacific Blue Psychological Services enrolled in Medicare?

Yes. Pacific Blue Psychological Services is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pacific Blue Psychological Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 30 clinicians in 4 Medicare specialties reassign their Medicare billing to Pacific Blue Psychological Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Marriage and Family Therapist (13), Clinical Psychologist (9) and Clinical Social Worker (5). Of these, 3 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pacific Blue Psychological Services was last updated on October 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.