Individual provider Active NPI

Kamran Eshtehardi, PHD

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1043767098
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33303 Issued in CA
Practice address
65 N Madison Ave Ste 707
Pasadena, CA 91101-2046
Phone
(818) 527-5218
NPI assigned
Sep 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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 33303 CA Primary

Addresses

Primary practice location

65 N Madison Ave Ste 707
Pasadena, CA 91101-2046

Mailing address

65 N Madison Ave Ste 707
Pasadena, CA 91101-2046
Phone (818) 527-5218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220622001761 CA Practitioner - Clinical Psychologist 0840679841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kamran Psychology Inc 2 clinicians

Practice addresses (Care Compare)

65 N Madison Ave
Suite 707
Pasadena, CA 91101-2046
Phone (818) 527-5218

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33303CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kamran Psychology Inc Clinical CurrentSince Apr 29, 2022 Accepting new patients

Locations

65 N Madison Ave
Ste 707
Pasadena, CA 91101
Phone (626) 765-7556

Organizations & group practices 1

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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1043767098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 707",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012046",
            "telephone_number": "818-527-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 707",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012046",
            "telephone_number": "818-527-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHTEHARDI",
        "first_name": "KAMRAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2022-04-29",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.