Individual provider Active NPI

Andrew C Dean, PH.D.

  • Clinical Neuropsychologist
  • Los Angeles, CA
National Provider Identifier
1073655064
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY21280 Issued in CA
Practice address
1654 S Orange Dr
Los Angeles, CA 90019-5314
Phone
(310) 825-5839
Fax
(310) 825-0812
NPI assigned
Feb 13, 2007
Last updated
Aug 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY21280 CA Primary
Clinical Psychologist 103TC0700X PSY21280 CA

Addresses

Primary practice location

1654 S Orange Dr
Los Angeles, CA 90019-5314

Mailing address

1654 S Orange Dr
Los Angeles, CA 90019-5314
Phone (310) 825-5839

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
I20080618000666 CA Practitioner - Clinical Psychologist 2769553734 Reassigns benefits to 1 organization
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UC RegentsGroup PAC ID 0749180453, 148 clinicians

Practice addresses (Care Compare)

Los Angeles, CA 90019
Phone (310) 892-3235

300 Medical PLZ
Suite 2200
Los Angeles, CA 90095-6968
Phone (310) 825-9989

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY21280CAMDClinical Psychologist
21280CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Clinical CurrentSince Feb 27, 2012 Accepting new patients

Locations

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

300 UCLA Medical Plz
Ste 2200
Los Angeles, CA 90095
Phone (310) 267-6810

760 Westwood Plz
#C8836
Los Angeles, CA 90095
Phone (310) 892-3235

760 Westwood Plz
Rm C8749
Los Angeles, CA 90095

760 Westwood Plz
Ste C8749
Los Angeles, CA 90095
Phone (310) 206-8100

760 Westwood Plz
Unit 951759
Los Angeles, CA 90095

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1073655064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 S ORANGE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900195314",
            "telephone_number": "310-825-5839",
            "fax_number": "310-825-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 S ORANGE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900195314",
            "telephone_number": "310-825-5839",
            "fax_number": "310-825-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY21280",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.