VICTORIA GRACE CARLSON PSYD
NPI 1417560673
Psychologist - Clinical in Los Angeles, CA

Active since August 27, 2020Opted out of Medicare · through Jul 11, 2027
3306 GLENDALE BLVD STE 3, LOS ANGELES, CA 90039(708) 767-7796 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 3, 2026, Jan 24, 2023, Aug 27, 2020 (3 updates tracked since 2020).

About Victoria Grace Carlson Psyd NPPES

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

VICTORIA GRACE CARLSON PSYD (NPI 1417560673) is an individual clinical provider in Los Angeles, California, licensed in California (PSY33537) and active in the NPI registry since August 2020. She has opted out of Medicare through July 11, 2027.

NPPES Registry Identity

NPI1417560673
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameVICTORIA GRACE CARLSONCredential: PSYD
Location Address3306 GLENDALE BLVD STE 3Los Angeles, CA 90039-1838
Mailing Address3306 Glendale Blvd Ste 3Los Angeles, CA 90039-1838 · (708) 767-7796
Sole ProprietorNo
Enumeration DateAugust 27, 2020
Last NPPES UpdateMarch 3, 20263 updates tracked since enumeration
NPPES CertifiedMarch 3, 2026
NPI 1417560673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses Licensed in CA · PSY33537 Licensed in CA · PSB94025549
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

3306 GLENDALE BLVD STE 3, Los Angeles, CA 90039

Other Names 1

Other Name (5)Grace Carlson Psyd

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Victoria Grace Carlson Psyd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 11, 2023 through July 11, 2027.

Opt-Out Effective DateJuly 11, 2023
Opt-Out In Effect ThroughJuly 11, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90039 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
3306 GLENDALE BLVD STE 3
LOS ANGELES, CA 90039

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 Victoria Carlson's NPI number?

The NPI number for Victoria Carlson is 1417560673. It was assigned to this individual provider in the NPPES registry on August 27, 2020. The provider is also known as Grace Carlson Psyd.

Where is Victoria Carlson located?

Victoria Carlson practices at 3306 Glendale Blvd Ste 3, Los Angeles, CA 90039. The listed phone number is (708) 767-7796.

What is Victoria Carlson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Victoria Carlson enrolled in Medicare?

No. Victoria Carlson has opted out of Medicare through July 11, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Victoria Carlson was last updated on March 3, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.