Mark Levine, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 18786 Issued in CA

Practice address

5455 Wilshire Blvd Ste 2104
Los Angeles, CA 90036-4290

Phone

(310) 285-3708

NPI assigned

Nov 15, 2011

Last updated

Nov 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1023395290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD STE 2104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364290",
            "telephone_number": "310-285-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 WILSHIRE BLVD STE 2104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364290",
            "telephone_number": "310-285-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 18786",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 18786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclynn Levine, DO
• Jacob Samuel Levine, MD
• Jesse Maurica Levine, MD, PHD
• Joel J. Levine, MD
• Linda Levine, LCSW
• Michael Levine, AMFT
• Michael M Levine, M.D.,
• Michael S Levine, M.D.
• Netty Levine, MS, RD, CDE
• Phillip Levine, MD

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.