Active NPI
Meredith Burneal Smith, PHD CLINICAL PSYCH
- Clinical Psychologist
- El Segundo, CA
National Provider Identifier
1144747296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY15082
- Practice address
- 1960 E Grand Ave Ste 940
El Segundo, CA 90245-5153 - Phone
- (909) 499-7009
- NPI assigned
- Aug 29, 2017
- 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 | PSY15082 | CA | Primary |
Addresses
Primary practice location
1960 E Grand Ave Ste 940
El Segundo, CA 90245-5153
Mailing address
1960 E Grand Ave Ste 940
El Segundo, CA 90245-5153
Phone (909) 499-7009
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 |
|---|---|---|---|
| PSY15082 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1144747296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1960 E GRAND AVE STE 940",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902455153",
"telephone_number": "909-499-7009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 E GRAND AVE STE 940",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902455153",
"telephone_number": "909-499-7009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MEREDITH",
"middle_name": "BURNEAL",
"name_prefix": "Dr.",
"credential": "PHD CLINICAL PSYCH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY15082",
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.