Individual provider Active NPI

Christine B. Dehaan, PH.D.

  • Clinical Psychologist
  • Woodland Hills, CA
National Provider Identifier
1154542215
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15638 Issued in CA
Practice address
21241 Ventura Blvd.
267
Woodland Hills, CA 91364
Phone
(818) 881-9776
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY15638 CA Primary

Addresses

Primary practice location

21241 Ventura Blvd.
267
Woodland Hills, CA 91364

Mailing address

13110 Seaview LN
Apt 245E
Seal Beach, CA 90740-3468
Phone (818) 345-0826

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
I20110620000270 CA Practitioner - Clinical Psychologist 4486832573 Practice locations: Long Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13110 Seaview LN
Apt 245E
Seal Beach, CA 90740-3468

5855 E Naples PLZ
Suite 112
Long Beach, CA 90803-5077
Phone (818) 881-9776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15638CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1154542215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13110 SEAVIEW LN",
            "address_2": "APT 245E",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907403468",
            "telephone_number": "818-345-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21241 VENTURA BLVD.",
            "address_2": "267",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91364",
            "telephone_number": "818-881-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "CHRISTINE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.