Individual provider Active NPI

Hannah N Krueger, PSY. D.

  • Health Psychologist
  • Glendale, CA
National Provider Identifier
1104432004
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
License
PSY32038 Issued in CA
Practice address
1530 East Chevy Chase Drive
Suite #204
Glendale, CA 91206-4139
Phone
(818) 230-7292
Fax
(818) 660-2694
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TH0004X PSY32038 CA Primary

Addresses

Primary practice location

1530 East Chevy Chase Drive
Suite #204
Glendale, CA 91206-4139

Mailing address

P.O. Box 251377
Glendale, CA 91225-1377
Phone (818) 230-7292

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
I20201122000053 CA Practitioner - Clinical Psychologist 3072924190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Calzadilla Psychological IncGroup PAC ID 8426210501, 2 clinicians

Practice addresses (Care Compare)

1530 E Chevy Chase Dr
Suite 204
Glendale, CA 91206-4139
Phone (818) 230-7292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY32038CAMDHealth Psychologist
32038CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Calzadilla Psychological Inc Single Specialty CurrentSince Nov 20, 2020 Accepting new patients

Locations

201 S Buena Vista St
Ste 240
Burbank, CA 91505
Phone (818) 563-9590

1530 E Chevy Chase Dr
Ste 204
Glendale, CA 91206
Phone (818) 241-7246

6801 Park Ter
Ste 250
Los Angeles, CA 90045

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1104432004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 251377",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912251377",
            "telephone_number": "818-230-7292",
            "fax_number": "818-660-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 EAST CHEVY CHASE DRIVE",
            "address_2": "SUITE #204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064139",
            "telephone_number": "818-230-7292",
            "fax_number": "818-660-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "HANNAH",
        "middle_name": "N",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "PSY32038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.