Active NPI
Mirjam Afeni Hatton, PSYD
- Psychologist
- Los Angeles, CA
National Provider Identifier
1073902235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34098
- Practice address
- 958 Venango Ave
Los Angeles, CA 90029-3020 - Phone
- (213) 537-8565
- NPI assigned
- Jan 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 98906 | CA | |
| Psychologist | 103T00000X | 34098 | CA | Primary |
Addresses
Primary practice location
958 Venango Ave
Los Angeles, CA 90029-3020
Mailing address
PO Box 27591
Los Angeles, CA 90027-0591
Phone (213) 537-8565
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 |
|---|---|---|---|---|
| I20231214002898 | CA | Practitioner - Clinical Psychologist | 7113376211 | Practice locations: Los Angeles, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
958 Venango Ave
Los Angeles, CA 90029-3020
Phone (213) 537-8565
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34098 | CA | MD | Clinical Social Worker |
| 98906 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708732800000",
"number": "1073902235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27591",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900270591",
"telephone_number": "213-537-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "958 VENANGO AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900293020",
"telephone_number": "213-537-8565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATTON",
"first_name": "MIRJAM",
"middle_name": "AFENI",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-12",
"last_updated": "2024-02-24",
"certification_date": "2024-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "98906",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "34098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; 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.