Randi McAllister Black, PHD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

PSY11499 Issued in CA

Practice address

1500 E Duarte Rd
Duarte, CA 91010

Phone

(626) 359-8111

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• California Cancer Specialists Medical Group Inc

  • Anesthesiology Physician
  • Duarte, CA
  • NPI 1912006636
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1144328873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5063",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910177163",
            "telephone_number": "626-775-3200",
            "fax_number": "626-775-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "91010",
            "telephone_number": "626-359-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCALLISTER BLACK",
        "first_name": "RANDI",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "PSY11499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY114990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Macy Akiyo Matsukawa, PA-C
• Mary Natalie Mauricio, LCSW
• Clare L Mazdisnian, CRNA
• Farhad Mazdisnian, MD
• Emma Elizabeth Heer Mazzilli, MSN, RN, AGACNP-BC
• Alexandra Teresa McCandless
• Lamia McClain
• Bethany Lai McDaniels, OTR/L
• Kevin McDonnell, M.D.
• Olivia Isabell McEachron, FNP-BC

• Child & Adolescent Psychiatry Physician in Duarte, CA
• Providers in Duarte, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.