Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Cody L Gustaveson, PHD

Individual provider Clinical Psychologist · NPI 1790303451

Dr. Cody L Gustaveson, PHD is a Clinical Psychologist in LA Mesa, California. Qualified in 2022, 4 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2020
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

8881 Fletcher Pkwy Ste 350-360
LA Mesa, CA 91942-3134
Phone: (858) 279-1223
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5893 Copley Dr, San Diego, CA 92111-7906 — (858) 616-5753

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 34321 (CA)

Record details

NPI number1790303451
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedJuly 9, 2020
Last updated in NPPESJanuary 24, 2025
Certification dateJanuary 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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