Poonam Nina Banerjee, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY24249 Issued in CA

Practice address

20409 Yorba Linda Blvd Ste 129-K
Yorba Linda, CA 92886-3042

Phone

(917) 370-6350

Fax

(949) 208-6981

NPI assigned

Apr 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nebula Health, LLCGroup PAC ID 8820482805, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Nebula Health, LLC

  • Adult Mental Health Clinic/Center
  • Riverside, CA
  • NPI 1194479501
  Medicare reassignment Care Compare group NPD
• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  Medicare reassignment NPD
• Butani Dermatology Inc

  • Dermatology Physician
  • Orange, CA
  • NPI 1568699106
  NPD (past)
• Butani Pain Clinic Inc

  • Neurology Physician
  • Orange, CA
  • NPI 1477780013
  NPD (past)
• John C. Storch, M.D., Inc.

  • Internal Medicine Physician
  • Newport Beach, CA
  • NPI 1144674169
  NPD (past)
• Promises Guest Village, Inc.

  dba Promises Guest Village

  • Adult Care Home Facility
  • Anaheim, CA
  • NPI 1548995541
  NPD (past)

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1104143197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20409 YORBA LINDA BLVD STE 129-K",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863042",
            "telephone_number": "917-370-6350",
            "fax_number": "949-208-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20409 YORBA LINDA BLVD STE 129-K",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863042",
            "telephone_number": "917-370-6350",
            "fax_number": "949-208-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJEE",
        "first_name": "POONAM",
        "middle_name": "NINA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-29",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY24249",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 24249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Bae, DDS
• Charles Bagwell, D.P.T.
• John Michael Bair, D.C.
• Kevin George Bakar, D.D.S.
• Vincent Balog I, DPT
• Marienelle Banez, M.D.
• Kyung Bang
• Christine Dragoo Baranick, PT
• Jerry Baranick, DPT
• Thomas Barker, M.D.

• Psychologist in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.

Verify at the official NPI Registry.