Individual provider Active NPI

Kristine Flanigan, PSYD

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1154060531
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35863 Issued in CA
Practice address
4929 Wilshire Blvd Ste 1000
Los Angeles, CA 90010-3825
Phone
(323) 743-1122
Fax
(323) 652-4301
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35863 CA Primary

Addresses

Primary practice location

4929 Wilshire Blvd Ste 1000
Los Angeles, CA 90010-3825

Mailing address

4929 Wilshire Blvd Ste 1000
Los Angeles, CA 90010-3825
Phone (323) 743-1122

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
I20251121002916 CA Practitioner - Clinical Psychologist 5294227757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1192 Vista Heights CT
Newbury Park, CA 91320-3604

433 S McCadden PL
Los Angeles, CA 90020-4819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35863CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren Muhlheim Past Accepting new patients

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": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1154060531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 WILSHIRE BLVD STE 1000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103825",
            "telephone_number": "323-743-1122",
            "fax_number": "323-652-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 WILSHIRE BLVD STE 1000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103825",
            "telephone_number": "323-743-1122",
            "fax_number": "323-652-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANIGAN",
        "first_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "35863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.