Individual provider Active NPI

Michael P Zelman, PSY.D.

  • Clinical Psychologist
  • El Monte, CA
National Provider Identifier
1104969187
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY18569 Issued in CA
Practice address
3208 Rosemead Blvd
2ND Floor
El Monte, CA 91731-2830
Phone
(626) 227-7014
Fax
(626) 227-7015
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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 PSY18569 CA Primary

Addresses

Primary practice location

3208 Rosemead Blvd
2ND Floor
El Monte, CA 91731-2830

Mailing address

3579 E Foothill Blvd
509
Pasadena, CA 91107-3119
Phone (626) 381-9482

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY18569CAMDClinical Psychologist
18569CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1104969187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 E FOOTHILL BLVD",
            "address_2": "509",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073119",
            "telephone_number": "626-381-9482",
            "fax_number": "708-810-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 ROSEMEAD BLVD",
            "address_2": "2ND FLOOR",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312830",
            "telephone_number": "626-227-7014",
            "fax_number": "626-227-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELMAN",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.