Active NPI
Joseph Boodaghi, PHD
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1033251293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 18010
- Practice address
- 9021 Melrose Av
306
Los Angeles, CA 90069 - Phone
- (310) 435-3290
- Fax
- (310) 273-6723
- NPI assigned
- Feb 13, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 18010 | CA | Primary |
Addresses
Primary practice location
9021 Melrose Av
306
Los Angeles, CA 90069
Mailing address
9021 Melrose Av
306
Los Angeles, CA 90069
Phone (310) 435-3290
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033251293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9021 MELROSE AV",
"address_2": "306",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90069",
"telephone_number": "310-435-3290",
"fax_number": "310-273-6723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9021 MELROSE AV",
"address_2": "306",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90069",
"telephone_number": "310-435-3290",
"fax_number": "310-273-6723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOODAGHI",
"first_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "18010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.