Active NPI
Kamran Eshtehardi, PHD
- Clinical Psychologist
- Pasadena, CA
National Provider Identifier
1043767098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 33303
- 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
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 | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 33303 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kamran Psychology Inc | Clinical | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.