DR. CODY L GUSTAVESON PHD
NPI 1790303451
Psychologist - Clinical in La Mesa, CA
About Dr. Cody L Gustaveson Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. CODY L GUSTAVESON PHD (NPI 1790303451) is an individual clinical provider in La Mesa, California, licensed in California (34321) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Cody L Gustaveson Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Cody Gustaveson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
El Cajon, CA 92020
- Reassigned Medicare billing, California enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91942 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LA MESA, CA 91942
LA MESA, CA 91942
LA MESA, CA 91942
LA MESA, CA 91942
LA MESA, CA 91942
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 Cody Gustaveson's NPI number?
The NPI number for Cody Gustaveson is 1790303451. It was assigned to this individual provider in the NPPES registry on July 9, 2020.
Where is Cody Gustaveson located?
Cody Gustaveson practices at 8881 Fletcher Pkwy Ste 350-360, La Mesa, CA 91942. The listed phone number is (858) 279-1223.
What is Cody Gustaveson's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Cody Gustaveson enrolled in Medicare?
Yes. Cody Gustaveson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Cody Gustaveson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Cody Gustaveson reassigns Medicare benefits to Clinic Ovis Psychological Group PC (El Cajon, CA). The 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 Cody Gustaveson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Cody Gustaveson was last updated on January 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.
# Dr. Cody L Gustaveson, PHD · NPI 1790303451
Clinical provider in La Mesa, California. Individual provider, active in the CMS NPPES registry since July 9, 2020.
## Identity
- **NPI:** 1790303451 (Entity type: Individual)
- **Enumerated:** July 9, 2020
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 34321 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 8881 FLETCHER PKWY STE 350-360, La Mesa, CA 91942-3134
- **Phone:** (858) 279-1223
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Clinic Ovis Psychological Group PC (NPI 1144064775, El Cajon, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** January 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790303451) · Data from the CMS NPPES public registry.