Individual provider Active NPI

Tiana Mondaca, PSY.D.

  • Clinical Psychologist
  • Calabasas, CA
National Provider Identifier
1063555746
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 20493 Issued in CA
Practice address
23801 Calabasas Rd
Suite 2036
Calabasas, CA 91302-1547
Phone
(818) 324-3698
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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 PSY 20493 CA Primary

Addresses

Primary practice location

23801 Calabasas Rd
Suite 2036
Calabasas, CA 91302-1547

Mailing address

23801 Calabasas Rd
Suite 2036
Calabasas, CA 91302-1547
Phone (818) 324-3698

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

State licenses

LicenseStateTypeSpecialty
PSY 20493CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1063555746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23801 CALABASAS RD",
            "address_2": "SUITE 2036",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021547",
            "telephone_number": "818-324-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23801 CALABASAS RD",
            "address_2": "SUITE 2036",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021547",
            "telephone_number": "818-324-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDACA",
        "first_name": "TIANA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.