Individual provider Active NPI

Kathryn Carr Tepper, PSYD

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1104369990
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY28754 Issued in CA
Practice address
2502 Hyperion Ave
Los Angeles, CA 90027-3317
Phone
(323) 632-9118
NPI assigned
Nov 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY28754 CA Primary

Addresses

Primary practice location

2502 Hyperion Ave
Los Angeles, CA 90027-3317

Mailing address

2502 Hyperion Ave
Los Angeles, CA 90027-3317

Other practice location 1

1758 Griffith Park Blvd
Los Angeles, CA 90026-1054
Phone (213) 807-6474

Other practice location 2

2110 W Sunset Blvd Ste P
Los Angeles, CA 90026
Phone (323) 632-9118

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY28754CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1104369990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 HYPERION AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900273317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 HYPERION AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900273317",
            "telephone_number": "323-632-9118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1758 Griffith Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900261054",
            "country_code": "US",
            "telephone_number": "213-807-6474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2110 W Sunset Blvd Ste P",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90026",
            "country_code": "US",
            "telephone_number": "323-632-9118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR TEPPER",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2024-01-09",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY28754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.