MEDICARE: DR. MICHELLE NOVOTNY PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	3147	CO
2	103TC0700X	Clinical Psychologist	PSY32774	CA

General Provider Information

NPI Number	:	1548411291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE NOVOTNY PSY.D.

Provider Business Mailing Address
First Line	:	1922 PENINSULA VERDE DR
Second Line	:
City	:	RANCHO PALOS VERDES
State	:	CA
Zip	:	90275-1053
Country	:	US
Telephone Number	:	303-882-8879
Fax Number	:

Provider Business Practice Location Address
First Line	:	1922 PENINSULA VERDE DR
Second Line	:
City	:	RANCHO PALOS VERDES
State	:	CA
Zip	:	90275-1053
Country	:	US
Telephone Number	:	303-882-8879
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2008
Last Update Date	:	06/27/2022

Similar Medicare Providers

1659265254 — LIANA TIANGCO NURSE PRACTITIONER
Practice Location Address:

7451 VIA SALSIPUEDES
RANCHO CUCAMONGA, CA
91730-1053

Practice Phone: 818-317-5526
Practice Fax:

1225199623 — DR. EDWARD LEONARD MONTWILL O.D.
Practice Location Address:

11749 SOUTHWEST HWY , SUITE C
PALOS HEIGHTS, IL
60463-1053

Practice Phone: 708-361-5236
Practice Fax: 708-361-5489

1841563681 — EDWARD L MONTWILL OD, LTD.
Practice Location Address:

11749 SOUTHWEST HWY # C
PALOS HEIGHTS, IL
60463-1053

Practice Phone: 708-361-5236
Practice Fax: 708-361-5489

1669732566 — PALOS VISION CORRECTIONS PC
Practice Location Address:

11749 SOUTHWEST HWY , C
PALOS HEIGHTS, IL
60463-1053

Practice Phone: 630-640-2464
Practice Fax: 708-361-5489

1417456195 — PALOS VISION CARE, INC
Practice Location Address:

11749 SOUTHWEST HWY STE D
PALOS HEIGHTS, IL
60463-1053

Practice Phone: 708-361-5236
Practice Fax: 708-361-5489

1316894850 — LIANA TOMASEVIC MS CCC SLP
Practice Location Address:

6221 PICARDIE RD
RANCHO PALOS VERDES, CA
90275-6551

Practice Phone: 310-292-9481
Practice Fax:

Directions to “ DR. MICHELLE NOVOTNY PSY.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.