Active NPI
Sophie Claire Feller, M.D.
- Psychiatry Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A161122
- Practice address
- 11500 W Olympic Blvd Ste 460
Los Angeles, CA 90064-1562 - Phone
- (323) 676-2474
- NPI assigned
- Apr 2, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 127
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.
-
- Internal Medicine Physician
- Poughkeepsie, NY
- NPI 1437358033
NY, Psychiatry
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lakewood, CO
- NPI 1104466630
Hospital
-
- General Acute Care Hospital
- Lakewood, CO
- NPI 1164430567
Hospital
-
- General Acute Care Hospital
- Lakewood, CO
- NPI 1740820273
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Geisinger ClinicPeacehealthCarilion Medical CenterLegacy Clinics LLCCatholic Health Initiatives ColoradoEdward W Sparrow Hospital AssociationAlamance Regional Medical Center IncAllina Health SystemSSM Regional Health ServicesMcLaren Medical GroupOnslow Memorial Hospital IncPeacehealth Medical GroupNuvance Health Medical Practice PCCarolinas Medical CenterThe Moses H Cone Memorial Hospital Operating Corporation
Practice addresses (Care Compare)
Los Angeles, CA 90025
Phone (213) 677-7924
Los Angeles, CA 90036
Phone (570) 271-6144
Los Angeles, CA 90066
Phone (907) 228-7660
1 Health Cir
Lexington, VA 24450-2448
Phone (540) 463-8141
1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711
11600 W 2ND PL
Sah Behavioral Health
Lakewood, CO 80228-1527
Phone (720) 321-0000
1210 W Saginaw St
Lansing, MI 48915-1927
1210 W Saginaw St FL
Lansing, MI 48915-1927
1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 538-7000
1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000
2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925
2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128
2505 Mission Dr
Jefferson City, MO 65109-9508
Phone (573) 681-3249
2701 W Edgewood Dr
101 SSM Health Medical Group Behaviora
Jefferson City, MO 65109-5890
Phone (573) 634-5303
2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-7500
2900 Lamb
700A
Christiansburg, VA 24073-6344
Phone (540) 731-7460
2900 Lamb Cir
Christiansburg, VA 24073-6344
Phone (540) 731-2992
3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone (907) 228-8300
317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345
3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6000
4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-7130
406 E Elm St
Carson City, MI 48811-9693
45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500
501 Billingsley Rd
Charlotte, NC 28211-1009
Phone 7044445881704444
Hospital & facility affiliations
- Vassar Brothers Medical Center
- Northern Dutchess Hospital
- Centura Health-St Anthony Hospital
- Onslow Memorial Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, MO, OR, TN, MN, WA, CT, NY, WI, PA, VA, MI, NC, AK, CO, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 16
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210517002643 | CA | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 13 organizations |
| I20221027001954 | MO | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
| I20221114000251 | OR | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 6 organizations |
| I20221128000329 | TN | Practitioner - Psychiatry | 0446580260 | |
| I20221205001465 | MN | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
| I20221219000723 | WA | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 8 organizations |
| I20221222001257 | CT | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
| I20230505002019 | NY | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 2 organizations |
| I20230907002001 | WI | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
| I20230918002756 | PA | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
| I20240304001670 | VA | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
| I20240312000640 | MI | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 2 organizations |
| I20240507002583 | NC | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 4 organizations |
| I20240709000647 | AK | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 2 organizations |
| I20241230000017 | CO | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
| I20250325002927 | TX | Practitioner - Psychiatry | 0446580260 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Arts, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201464 | AK | MD | Psychiatry Physician |
| A161122 | CA | MD | Psychiatry Physician |
| DR.0074158 | CO | MD | Psychiatry Physician |
| 72606 | MN | MD | Psychiatry Physician |
| MD212909 | OR | MD | Psychiatry Physician |
| 0101277061 | VA | MD | Psychiatry Physician |
Practice roles (60 of 62)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Medical Center | Current | Accepting new patients | |
| County of Los Angeles | Current | Accepting new patients | |
| Tower Health Medical Group | Current | Accepting new patients | |
| Peacehealth Medical Group | Psychiatry | Current | Accepting new patients |
| Alamance Regional Medical Center, Inc | Current | Accepting new patients | |
| Nuvance Health Medical Practice PC | Psychiatry | Current | Accepting new patients |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Carolinas Medical Center | Psychiatry | Current | Accepting new patients |
| Peacehealth | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Tower Health Medical Group | Current | Accepting new patients | |
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Carilion Medical Center | Current | Accepting new patients | |
| Peacehealth Medical Group Cottage Grove | Current | Accepting new patients | |
| Carilion Medical Center | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Alcott Center for Mental Health Services | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| The Moses H. Cone Memorial Hospital Operating Corporation | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| SSM Regional Health Services | Current | Accepting new patients | |
| Peacehealth | Psychiatry | Current | Accepting new patients |
| Peacehealth | Current | Accepting new patients | |
| Peacehealth Medical Group | Current | Accepting new patients | |
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Peacehealth | Psychiatry | Current | Accepting new patients |
| Edward W. Sparrow Hospital Association | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| McLaren Medical Group | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| County of Los Angeles | Current | Accepting new patients | |
| Tower Health Medical Group | Current | Accepting new patients | |
| Memorial Hermann Medical Group | Current | Accepting new patients | |
| Onslow Memorial Hospital Inc | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Alamance Regional Medical Center, Inc. | Current | Accepting new patients | |
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients | |
| McLaren Medical Group | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Edward W Sparrow Hospital Association | Current | Accepting new patients | |
| SSM Regional Health Services | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Edward W. Sparrow Hospital Association | Psychiatry | Current | Accepting new patients |
| Carolinas Medical Center | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| McLaren Medical Group | Psychiatry | Current | Accepting new patients |
| County of Los Angeles Auditor Controller | Current | Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Past | Accepting new patients |
Locations (25 of 56)
3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104
10549 Jefferson Blvd
Culver City, CA 90232
Phone 3107852121 ext. 202
10559 Jefferson Blvd
Ste A
Culver City, CA 90232
Phone (310) 785-2121
14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303
9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193
11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010
41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551
1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376
114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001
8175 Reliable Pkwy
Chicago, IL 60686
7655 Solutions Ctr
Chicago, IL 60677
5979 Lakeshore Rd
Fort Gratiot, MI 48059
Phone (810) 385-6370
1210 W Saginaw St
Fl 2
Lansing, MI 48915
Phone (517) 364-7575
2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500
1254 N Main St
Lapeer, MI 48446
Phone (810) 664-4531
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
2701 W Edgewood Dr
Ste 101
Jefferson Cty, MO 65109
Phone (573) 634-5303
1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000
501 Billingsley Rd
Charlotte, NC 28211
Phone (704) 358-2700
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
501 Billingsley Rd
#B
Charlotte, NC 28211
Phone (704) 444-2400
509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970
Interoperability endpoints
- sfeller2998468@carolinashealthcaresystem.direct-ci.com
- sfeller437981@direct-ehr-ssmhc.com
Specialties & licenses 9
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A161122 | CA | Primary |
| Psychiatry Physician | 2084P0800X | 0101277061 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | MD212909 | OR | |
| Psychiatry Physician | 2084P0800X | 67044 | TN | |
| Psychiatry Physician | 2084P0800X | 201464 | AK | |
| Psychiatry Physician | 2084P0800X | DR.0074158 | CO | |
| Psychiatry Physician | 2084P0800X | EMC0003820 | MI | |
| Psychiatry Physician | 2084P0800X | 72606 | MN |
Addresses
NPPES NPI RegistryPrimary practice location
11500 W Olympic Blvd Ste 460
Los Angeles, CA 90064-1562
Mailing address
11500 W Olympic Blvd Ste 460
Los Angeles, CA 90064-1562
Other practice location 1
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000
Other practice location 2
4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (612) 262-1220
Other practice location 3
245 Medical Park Dr
Marion, VA 24354-1100
Phone (276) 378-1000
Other practice location 4
2030 Temple Hill Rd
Erwin, TN 37650-8721
Phone (423) 743-3141
Other practice location 5
1901 S Shady St
Mountain City, TN 37683-2021
Phone (423) 727-1100
Other practice location 6
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000
Other practice location 7
921 Gessner Rd Ste 317
Houston, TX 77024-2501
Phone (713) 242-3768
Other practice location 8
400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
Other practice location 9
312 Hospital Dr
Clintwood, VA 24228-6786
Phone (276) 926-0300
Other practice location 10
2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-7000
Other practice location 11
1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1300
Other practice location 12
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121
Other practice location 13
3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone (907) 228-7660
Other practice location 14
2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-8025
Other practice location 15
1519 Main St
Sneedville, TN 37869-3657
Phone (423) 733-5000
Other practice location 16
1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000
Other practice location 17
1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (276) 523-3111
Other practice location 18
11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (720) 321-0000
Other practice location 19
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000
Other practice location 20
58 Carroll Street
Lebanon, VA 24266-4510
Phone (276) 883-8000
Other practice location 21
851 Locust St
Rogersville, TN 37857-2407
Phone (423) 921-7000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2025.
{
"created_epoch": "1427932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757980800000",
"number": "1134514540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11500 W OLYMPIC BLVD STE 460",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11500 W OLYMPIC BLVD STE 460",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641562",
"telephone_number": "323-676-2474"
}
],
"practiceLocations": [
{
"address_1": "16000 Johnston Memorial Dr",
"address_purpose": "LOCATION",
"city": "Abingdon",
"state": "VA",
"postal_code": "242117664",
"country_code": "US",
"telephone_number": "276-258-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4050 Coon Rapids Blvd NW",
"address_purpose": "LOCATION",
"city": "Coon Rapids",
"state": "MN",
"postal_code": "554332522",
"country_code": "US",
"telephone_number": "612-262-1220",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "245 Medical Park Dr",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "VA",
"postal_code": "243541100",
"country_code": "US",
"telephone_number": "276-378-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2030 Temple Hill Rd",
"address_purpose": "LOCATION",
"city": "Erwin",
"state": "TN",
"postal_code": "376508721",
"country_code": "US",
"telephone_number": "423-743-3141",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1901 S Shady St",
"address_purpose": "LOCATION",
"city": "Mountain City",
"state": "TN",
"postal_code": "376832021",
"country_code": "US",
"telephone_number": "423-727-1100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Med Tech Pkwy",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376042277",
"country_code": "US",
"telephone_number": "423-302-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "921 Gessner Rd Ste 317",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770242501",
"country_code": "US",
"telephone_number": "713-242-3768",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 N State Of Franklin Rd",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376046035",
"country_code": "US",
"telephone_number": "423-431-6111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "312 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Clintwood",
"state": "VA",
"postal_code": "242286786",
"country_code": "US",
"telephone_number": "276-926-0300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2000 Brookside Dr",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376604627",
"country_code": "US",
"telephone_number": "423-857-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1501 W Elk Ave",
"address_purpose": "LOCATION",
"city": "Elizabethton",
"state": "TN",
"postal_code": "376432874",
"country_code": "US",
"telephone_number": "423-542-1300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Park Blvd",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376207430",
"country_code": "US",
"telephone_number": "423-844-1121",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3100 Tongass Ave",
"address_purpose": "LOCATION",
"city": "Ketchikan",
"state": "AK",
"postal_code": "999015746",
"country_code": "US",
"telephone_number": "907-228-7660",
"fax_number": "907-228-8549",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2017 Jefferson St SW",
"address_purpose": "LOCATION",
"city": "Roanoke",
"state": "VA",
"postal_code": "240142419",
"country_code": "US",
"telephone_number": "540-981-8025",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1519 Main St",
"address_purpose": "LOCATION",
"city": "Sneedville",
"state": "TN",
"postal_code": "378693657",
"country_code": "US",
"telephone_number": "423-733-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1420 Tusculum Blvd",
"address_purpose": "LOCATION",
"city": "Greeneville",
"state": "TN",
"postal_code": "377454279",
"country_code": "US",
"telephone_number": "423-787-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1990 Holton Ave E",
"address_purpose": "LOCATION",
"city": "Big Stone Gap",
"state": "VA",
"postal_code": "242193350",
"country_code": "US",
"telephone_number": "276-523-3111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11600 W 2nd Pl",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "CO",
"postal_code": "802281527",
"country_code": "US",
"telephone_number": "720-321-0000",
"fax_number": "720-321-4165",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "130 W Ravine Rd",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376603837",
"country_code": "US",
"telephone_number": "423-224-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "58 Carroll Street",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "VA",
"postal_code": "242664510",
"country_code": "US",
"telephone_number": "276-883-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "851 Locust St",
"address_purpose": "LOCATION",
"city": "Rogersville",
"state": "TN",
"postal_code": "378572407",
"country_code": "US",
"telephone_number": "423-921-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FELLER",
"first_name": "SOPHIE",
"middle_name": "CLAIRE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-02",
"last_updated": "2025-09-16",
"certification_date": "2025-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A161122",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101277061",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD212909",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TN",
"license": "67044",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AK",
"license": "201464",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "DR.0074158",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "EMC0003820",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "72606",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.