Individual provider Active NPI

Ramani S Durvasula, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1033367388
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15741 Issued in CA
Practice address
5151 State University Drive
Csula - King Hall
Los Angeles, CA 90032
Phone
(310) 435-8010
Fax
(323) 343-2281
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY15741 CA Primary

Addresses

Primary practice location

5151 State University Drive
Csula - King Hall
Los Angeles, CA 90032

Mailing address

5151 State University Drive
Csula - King Hall
Los Angeles, CA 90032
Phone (310) 435-8010

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15741CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1033367388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 STATE UNIVERSITY DRIVE",
            "address_2": "CSULA - KING HALL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90032",
            "telephone_number": "310-435-8010",
            "fax_number": "323-343-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 STATE UNIVERSITY DRIVE",
            "address_2": "CSULA - KING HALL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90032",
            "telephone_number": "310-435-8010",
            "fax_number": "323-343-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURVASULA",
        "first_name": "RAMANI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15741",
            "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 Aug 28, 2008; 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.