Individual provider Active NPI

Jamie Leigh Nierenberg, PSYD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1063840031
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY35103 Issued in CA
Practice address
1891 Effie St
Los Angeles, CA 90026-1793
Phone
(323) 644-2000
NPI assigned
Oct 29, 2013
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY35103 CA Primary
Psychologist 103T00000X PSY35103 CA

Addresses

Primary practice location

1891 Effie St
Los Angeles, CA 90026-1793

Mailing address

1891 Effie St
Los Angeles, CA 90026-1793
Phone (323) 644-2000

Other names 1

  • Jamie Huber Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY35103CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Children's Society, Inc Past Accepting new patients
South Coast Children's Society, Inc PastSince Sep 1, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1063840031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 EFFIE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261793",
            "telephone_number": "323-644-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 EFFIE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261793",
            "telephone_number": "323-644-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERENBERG",
        "first_name": "JAMIE",
        "middle_name": "LEIGH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35103",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY35103",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "HUBER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.