Individual provider Active NPI

Janice Patricia Ferris, PH.D.

  • Clinical Psychologist
  • Santa Monica, CA
National Provider Identifier
1083849848
Registry record updated May 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
14982 Issued in CA
Practice address
3101 Ocean Park Blvd Ste 100
Santa Monica, CA 90405-3029
Phone
(310) 804-1743
Fax
(424) 672-3223
NPI assigned
May 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 14982 CA Primary

Addresses

Primary practice location

3101 Ocean Park Blvd Ste 100
Santa Monica, CA 90405-3029

Mailing address

3101 Ocean Park Blvd Ste 100
Santa Monica, CA 90405-3029
Phone (310) 804-1743

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
I20140117000082 CA Practitioner - Clinical Psychologist 1052549367 Practice locations: Los Angeles, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
David L Friedman MD a Professional Corporation Psychologist PastSince Oct 27, 2009 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1083849848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 OCEAN PARK BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053029",
            "telephone_number": "310-804-1743",
            "fax_number": "424-672-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 OCEAN PARK BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053029",
            "telephone_number": "310-804-1743",
            "fax_number": "424-672-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRIS",
        "first_name": "JANICE",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "14982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.