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DR. BETHANY VAUDREY PSYD
NPI 1902152507
Psychologist - Clinical in Agoura Hills, CA

Active since August 01, 2012Opted out of Medicare · through Oct 24, 2027
28328 AGOURA RD STE 102, AGOURA HILLS, CA 91301(818) 918-0574 Get Directions Write a Review

NPPES record last updated: October 23, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 23, 2019, Sep 14, 2016 (2 updates tracked since 2016).

About Dr. Bethany Vaudrey Psyd NPPES

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

DR. BETHANY VAUDREY PSYD (NPI 1902152507) is an individual clinical provider in Agoura Hills, California, licensed in California (PSY28607) and active in the NPI registry since August 2012. She has opted out of Medicare through October 24, 2027 and maintains a secondary practice location in Northridge.

NPPES Registry Identity

NPI1902152507
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. BETHANY VAUDREYCredential: PSYD
Location Address28328 AGOURA RD STE 102Agoura Hills, CA 91301
Mailing Address28328 Agoura Rd Ste 102Agoura Hills, CA 91301-2739 · (818) 918-0574
Phone(818) 918-0574
Sole ProprietorYes
Enumeration DateAugust 1, 2012
Last NPPES UpdateOctober 23, 20192 updates tracked since enumeration
✔ NPI 1902152507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY28607
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.
28328 AGOURA RD STE 102, Agoura Hills, CA 91301
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Secondary Practice Location 1

Location 18550 Balboa Blvd Ste 150Northridge, CA 91325-3579 · Phone (818) 739-5612

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Bethany Vaudrey 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 October 24, 2025 through October 24, 2027.

Opt-Out Effective DateOctober 24, 2025
Opt-Out In Effect ThroughOctober 24, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

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

THERESA GISELL INCHAURREGUI PSYD
Psychologist (Clinical)
28328 AGOURA RD STE 102
AGOURA HILLS, CA 91301
Los Angeles County (818) 900-5303
SUNLIGHT PSYCHOLOGICAL SERVICES
Psychologist (Clinical Child & Adolescent)
28328 AGOURA RD STE 102
AGOURA HILLS, CA 91301
Los Angeles County (818) 918-0574
SOPHIA RENEE BERGER MA
Psychologist (Clinical)
28328 AGOURA RD STE 102
AGOURA HILLS, CA 91301
Los Angeles County (818) 900-5939

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 Bethany Vaudrey's NPI number?

The NPI number for Bethany Vaudrey is 1902152507. It was assigned to this individual provider in the NPPES registry on August 1, 2012.

Where is Bethany Vaudrey located?

Bethany Vaudrey practices at 28328 Agoura Rd Ste 102, Agoura Hills, CA 91301. The listed phone number is (818) 918-0574.

What is Bethany Vaudrey's specialty?

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

Is Bethany Vaudrey enrolled in Medicare?

No. Bethany Vaudrey has opted out of Medicare through October 24, 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 Bethany Vaudrey was last updated on October 23, 2019. 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.