Charles Kodimer, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 6629 Issued in CA

Practice address

10927 Downey Ave Ste C
Downey, CA 90241-3739

Phone

(562) 861-6180

Fax

(951) 694-0553

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1977

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Charles Kodimer PHD Psychological

  • Clinical Psychologist
  • Downey, CA
  • NPI 1891749727

  Clinical Neuropsychologist

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1023040599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41934 MAIN ST STE 203",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902714",
            "telephone_number": "562-861-6180",
            "fax_number": "951-694-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10927 DOWNEY AVE STE C",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902413739",
            "telephone_number": "562-861-6180",
            "fax_number": "951-694-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODIMER",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 6629",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 6629",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 6318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Knight
• Priscilla Lee Knott, BA
• Alexus Rose Knox
• Bryce Ko, M.D.
• Kwan Hyoung Ko, L AC
• Garo H Kodjababian, MD
• Satjiv Kohli, M.D.
• Sienna Orange Koizumi
• Christopher Kolleff
• Philip Konopa

• Clinical Psychologist in Downey, CA
• Providers in Downey, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.