Individual provider Active NPI

Anne Davison Panofsky, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1083778963
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY5325 Issued in CA
Practice address
10801 National Blvd
Ste 200
Los Angeles, CA 90064-4148
Phone
(310) 472-4648
Fax
(310) 476-4684
NPI assigned
Dec 21, 2006
Last updated
Feb 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY5325 CA Primary

Addresses

Primary practice location

10801 National Blvd
Ste 200
Los Angeles, CA 90064-4148

Mailing address

8313 Raintree Cir
#208
Culver City, CA 90230-4447
Phone (310) 472-4648

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
I20120412000618 CA Practitioner - Clinical Psychologist 1355518424 Practice locations: Los Angeles, CA; Whittier, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10801 National Blvd
Suite 200
Los Angeles, CA 90064-4148
Phone (310) 472-4648

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY5325CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1083778963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8313 RAINTREE CIR",
            "address_2": "#208",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304447",
            "telephone_number": "310-472-4648",
            "fax_number": "310-476-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 NATIONAL BLVD",
            "address_2": "STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900644148",
            "telephone_number": "310-472-4648",
            "fax_number": "310-476-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOFSKY",
        "first_name": "ANNE",
        "middle_name": "DAVISON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY5325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.