Bruce Ellman, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

21012 Issued in CA

Practice address

415 N Camden Dr Ste 106
Beverly Hills, CA 90210-4436

Phone

(323) 819-9991

NPI assigned

May 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 8, 2025 through Nov 8, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1033775382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CAMDEN DR STE 106",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104436",
            "telephone_number": "323-819-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CAMDEN DR STE 106",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104436",
            "telephone_number": "323-819-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLMAN",
        "first_name": "BRUCE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "21012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rayan Abdo Elkattah, M.D.
• Leah Ellenberg, PH.D.
• Ellie Adhami Psychotherapy Inc.
• Jonathan C Ellis, MD
• Tyler Ellis
• Rachel Ann Elsasser, D.O.
• Elsz Medical, Inc., a Professional Corporation
• Rebecca Elyasi
• Navah Nazanin Elyasian, LMFT
• Mary Elyasnik

• Psychologist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.