Individual provider Active NPI

Mai Lai Breech, PSY.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1164260535
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34726 Issued in CA
Practice address
10845 Lindbrook Drive
Suite 202
Los Angeles, CA 90024
Phone
(310) 351-1601
NPI assigned
Jul 18, 2024
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 PSY34726 CA Primary

Addresses

Primary practice location

10845 Lindbrook Drive
Suite 202
Los Angeles, CA 90024

Mailing address

10845 Lindbrook Drive
Suite 202
Los Angeles, CA 90024
Phone (310) 351-1601

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

State licenses

LicenseStateTypeSpecialty
PSY34726CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1164260535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 LINDBROOK DRIVE",
            "address_2": "SUITE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90024",
            "telephone_number": "310-351-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10845 LINDBROOK DRIVE",
            "address_2": "SUITE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90024",
            "telephone_number": "310-351-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREECH",
        "first_name": "MAI",
        "middle_name": "LAI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.