Active NPI
Maria Nazarian, PH.D.
- Clinical Psychologist
- El Segundo, CA
National Provider Identifier
1134423882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY24213
- Practice address
- 877 N Douglas St
El Segundo, CA 90245-2801 - Phone
- (310) 616-6722
- Fax
- (310) 536-0215
- NPI assigned
- Jan 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY24213 | CA | Primary |
Addresses
Primary practice location
877 N Douglas St
El Segundo, CA 90245-2801
Mailing address
877 N Douglas St
El Segundo, CA 90245-2801
Phone (310) 616-6722
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY24213 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Megan Sullaway and Edward Dunbar | Past | Accepting new patients |
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.
-
- Psychologist
- El Segundo, CA
- NPI 1447422357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1134423882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "877 N DOUGLAS ST",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902452801",
"telephone_number": "310-616-6722",
"fax_number": "310-536-0215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 N DOUGLAS ST",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902452801",
"telephone_number": "310-616-6722",
"fax_number": "310-536-0215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAZARIAN",
"first_name": "MARIA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-10",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY24213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.