Active NPI
Michael Robert Pines, PHD
- Clinical Psychologist
- Northridge, CA
National Provider Identifier
1154556645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY7793
- Practice address
- 9010 Reseda Blvd
Suite 217
Northridge, CA 91324-3921 - Phone
- (818) 983-6359
- NPI assigned
- May 27, 2009
- Last updated
- May 27, 2009
- Sex
- Male
- 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 | PSY7793 | CA | Primary |
Addresses
Primary practice location
9010 Reseda Blvd
Suite 217
Northridge, CA 91324-3921
Mailing address
14431 Ventura Blvd
#271
Sherman Oaks, CA 91423-2606
Phone (818) 983-6359
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY7793 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1154556645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14431 VENTURA BLVD",
"address_2": "#271",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914232606",
"telephone_number": "818-983-6359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9010 RESEDA BLVD",
"address_2": "SUITE 217",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913243921",
"telephone_number": "818-983-6359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINES",
"first_name": "MICHAEL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-27",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY7793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.