Individual provider Active NPI

Seda Terzyan, PHD

  • Clinical Psychologist
  • Corona del Mar, CA
National Provider Identifier
1114464328
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY29251 Issued in CA
Practice address
1550 Bayside Dr Ste 2
Corona del Mar, CA 92625-1711
Phone
(949) 783-9590
NPI assigned
Jan 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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 PSY29251 CA Primary

Addresses

Primary practice location

1550 Bayside Dr Ste 2
Corona del Mar, CA 92625-1711

Mailing address

1550 Bayside Dr Ste 2
Corona del Mar, CA 92625-1711
Phone (818) 395-2238

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
I20180711003007 CA Practitioner - Clinical Psychologist 9133475742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seda Terzyan, a Psychological CorporationGroup PAC ID 7315293925, 4 clinicians

Practice addresses (Care Compare)

1550 Bayside Dr
Corona del Mar, CA 92625-1711
Phone (949) 783-9590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY29251CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Seda Terzyan, a Psychological Corporation Clinical CurrentSince Jun 20, 2018 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

1550 Bayside Dr
Ste 2
Corona del Mar, CA 92625
Phone (909) 239-9738

1550 Bayside Dr
Corona del Mar, CA 92625
Phone (949) 280-7729

1440 N Harbor Blvd
Ste 255
Fullerton, CA 92835
Phone (909) 239-9738

250 Newport Center Dr
Ste M106
Newport Beach, CA 92660
Phone (949) 783-9590

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: seda.terzyan.1@17999.direct.athenahealth.com

Organizations & group practices 2

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1114464328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 BAYSIDE DR STE 2",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251711",
            "telephone_number": "818-395-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 BAYSIDE DR STE 2",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251711",
            "telephone_number": "949-783-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERZYAN",
        "first_name": "SEDA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

Verify at the official NPI Registry.