Individual provider Active NPI

Ariel Eckfeld, PH.D.

  • Clinical Neuropsychologist
  • Corona del Mar, CA
National Provider Identifier
1033545801
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
30913 Issued in CA
Practice address
1550 Bayside Dr Ste 2
Corona del Mar, CA 92625-1711
Phone
(949) 783-9590
NPI assigned
Sep 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 30913 CA Primary

Addresses

Primary practice location

1550 Bayside Dr Ste 2
Corona del Mar, CA 92625-1711

Mailing address

578 S Eveningsong LN
Anaheim, CA 92808-1616
Phone (973) 951-6940

Other practice location 1

1339 20th St
Santa Monica, CA 90404-2033
Phone (310) 829-8921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 3, 2024 through Jan 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
30913CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation PastSince Sep 1, 2019 Accepting new patients
Matthew N. Koury, MD, MPH a Professional Corporation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1033545801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 S EVENINGSONG LN",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081616",
            "telephone_number": "973-951-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 BAYSIDE DR STE 2",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251711",
            "telephone_number": "949-783-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1339 20th St",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904042033",
            "country_code": "US",
            "telephone_number": "310-829-8921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECKFELD",
        "first_name": "ARIEL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "30913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

Verify at the official NPI Registry.