Active NPI
Aimee Joy Samuels, PH.D.
- Clinical Psychologist
- Commerce, CA
National Provider Identifier
1083745384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY21775
- Practice address
- 2450 S Atlantic Blvd
Suite 101
Commerce, CA 90040-1200 - Phone
- (323) 318-9960
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- 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 | PSY21775 | CA | Primary |
Addresses
Primary practice location
2450 S Atlantic Blvd
Suite 101
Commerce, CA 90040-1200
Mailing address
2450 S Atlantic Blvd
Suite 101
Commerce, CA 90040-1200
Phone (323) 318-9960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENK1733 | Other | CA | L.A. DPT OF MENTAL HEALTH |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21775 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penny Lane | Past | Accepting new patients | |
| Penny Lane | Past | 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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Commerce, CA
- NPI 1043491756
-
- Community/Behavioral Health Agency
- Commerce, CA
- NPI 1558664631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337126400000",
"number": "1083745384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 S ATLANTIC BLVD",
"address_2": "SUITE 101",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900401200",
"telephone_number": "323-318-9960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 S ATLANTIC BLVD",
"address_2": "SUITE 101",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900401200",
"telephone_number": "323-318-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "AIMEE",
"middle_name": "JOY",
"name_prefix": "Ms.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2012-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY21775",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L.A. DPT OF MENTAL HEALTH",
"identifier": "ENK1733",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Commerce, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.