Pacific Blue Psychological Services
NPI 1124678719ActiveOrganization· Psychologist· Sherman Oaks, CA
Psychologist in Sherman Oaks, California, registered in NPPES in September 2019. The authorized official on file is John Carroll, PSYD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124678719 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 16, 2019 |
| Last updated in NPPES | Oct 9, 2020 |
| Certified by provider | Oct 9, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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