Sydney Pranitis, PSY.D. – Clinical Psychologist

Key facts

NPI: 1104498435
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Psychologist 103TC0700X
License: PSY35454 (CA)
Practice address: 2301 Hyperion Ave # a
Los Angeles, CA 90027-4711
Phone: (800) 726-3890
NPI assigned: Jul 15, 2021
Sex: Female
Sole proprietor: No

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.

Silver Lake Psychology Inc. Psychologist · Los Angeles, CA · NPI 1932651817

Medicare reassignment Care Compare group NPD CA

Medicare Care Compare profile

Specialty: Clinical Psychologist
Education: Other, 2022
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: Silver Lake Psychology Inc (19 clinicians)

Practice addresses (Care Compare)

2301 Hyperion Ave
Suite a
Los Angeles, CA 90027-4711
Phone (310) 726-3890

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20250307000056	CA	Practitioner - Clinical Psychologist	5698296531	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
PSY35454	CA	MD	Clinical Psychologist

Practice roles

Organization	Specialty	Status	New patients
Silver Lake Psychology Inc.		Current since Nov 14, 2024	Accepting new patients

Locations

2301 Hyperion Ave
#A
Los Angeles, CA 90027
Phone (310) 726-3890

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Student in an Organized Health Care Education/Training Program	390200000X		CA
Clinical Psychologist	103TC0700X	PSY35454	CA	Yes

Addresses

Primary practice location

2301 Hyperion Ave # a
Los Angeles, CA 90027-4711

Mailing address

2301 Hyperion Ave # a
Los Angeles, CA 90027-4711
Phone (800) 726-3890

Other practice location 1

3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533
Phone (213) 381-1250

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 4, 2024.

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1104498435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HYPERION AVE # A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900274711",
            "telephone_number": "800-726-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HYPERION AVE # A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900274711",
            "telephone_number": "800-726-3890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3580 Wilshire Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900102533",
            "country_code": "US",
            "telephone_number": "213-381-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRANITIS",
        "first_name": "SYDNEY",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

All providers in Los Angeles, CA · Clinical Psychologist in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.