Individual provider Active NPI

Allen M. Yasser, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1104044221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY3856 Issued in CA
Practice address
9911 W Pico Blvd
Los Angeles, CA 90035-2703
Phone
(310) 277-2796
Fax
(310) 277-8903
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY3856 CA Primary

Addresses

Primary practice location

9911 W Pico Blvd
Los Angeles, CA 90035-2703

Mailing address

9911 W Pico Blvd
Los Angeles, CA 90035-2703
Phone (310) 277-2796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2014 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY3856CAMDClinical Psychologist
3856CAMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Institute Past 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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104044221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352703",
            "telephone_number": "310-277-2796",
            "fax_number": "310-277-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9911 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352703",
            "telephone_number": "310-277-2796",
            "fax_number": "310-277-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSER",
        "first_name": "ALLEN",
        "middle_name": "M.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY3856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.