DR. PETER S THEODORE PHD
NPI 1487080651
Psychologist in Los Angeles, CA

Active since September 19, 2013PECOS Enrolled
116 N ROBERTSON BLVD, 805, LOS ANGELES, CA 90048(626) 270-3351(626) 284-0550 Get Directions Write a Review

NPPES record last updated: September 19, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Peter S Theodore Phd NPPES

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

DR. PETER S THEODORE PHD (NPI 1487080651) is an individual psychologist in Los Angeles, California, licensed in California (PSY22511) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487080651
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. PETER S THEODORECredential: PHD
Location Address116 N ROBERTSON BLVD, 805Los Angeles, CA 90048-3103
Mailing Address7428 Hollywood Blvd, 202Los Angeles, CA 90046-2800 · (626) 270-3351 · Fax (626) 284-0550
Fax(626) 284-0550
Sole ProprietorYes
Enumeration DateSeptember 19, 2013
NPI 1487080651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY22511
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.

116 N ROBERTSON BLVD, Los Angeles, CA 90048

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Peter S Theodore Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 11

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

Psychiatry & Neurology (Psychiatry)
116 N ROBERTSON BLVD, SUITE 806
LOS ANGELES, CA 90048
Psychiatry & Neurology (Psychiatry)
116 N ROBERTSON BLVD, #907
LOS ANGELES, CA 90048
Psychiatry & Neurology (Psychiatry)
116 N ROBERTSON BLVD, #806
LOS ANGELES, CA 90048
Psychiatry & Neurology (Psychiatry)
116 N ROBERTSON BLVD
LOS ANGELES, CA 90048
Counselor
116 N ROBERTSON BLVD, SUITE 805
LOS ANGELES, CA 90048
Psychologist
116 N ROBERTSON BLVD, SUITE 706
LOS ANGELES, CA 90048
Psychologist
116 N ROBERTSON BLVD, SUITE 807
LOS ANGELES, CA 90048
Psychiatry & Neurology (Psychiatry)
116 N ROBERTSON BLVD, SUITE 805
LOS ANGELES, CA 90048

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487080651, enumerated as an "individual" on September 19, 2013.

The provider is located at 116 N ROBERTSON BLVD 805 LOS ANGELES, CA 90048 and the phone number is (626) 270-3351.

Psychologist with taxonomy code 103T00000X.