Active NPI
Christine Louise Desandre, PSY.D.
- Clinical Psychologist
- Cerritos, CA
National Provider Identifier
1013108547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY27054
- Practice address
- 17215 Studebaker Rd
Suite 110
Cerritos, CA 90703-2548 - Phone
- (562) 860-2210
- NPI assigned
- Aug 8, 2007
- Last updated
- Jun 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | ||
| Clinical Psychologist | 103TC0700X | PSY27054 | CA | Primary |
| Forensic Psychologist | 103TF0200X | NU | ||
| Group Psychotherapy Psychologist | 103TP2701X | NU | ||
| Health Psychologist | 103TH0004X | NU |
Addresses
Primary practice location
17215 Studebaker Rd
Suite 110
Cerritos, CA 90703-2548
Mailing address
450 Bauchet St
Los Angeles, CA 90012-2907
Phone (213) 893-5429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY27054 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654732800000",
"number": "1013108547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 BAUCHET ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900122907",
"telephone_number": "213-893-5429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17215 STUDEBAKER RD",
"address_2": "SUITE 110",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907032548",
"telephone_number": "562-860-2210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANDRE",
"first_name": "CHRISTINE",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-08",
"last_updated": "2022-06-09",
"certification_date": "2022-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY27054",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.