Active NPI
Jerry Dash, PH.D.
- Clinical Psychologist
- Burbank, CA
National Provider Identifier
1164587846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 5344
- Practice address
- 421 E Angeleno Ave
Suite 205
Burbank, CA 91501-2286 - Phone
- (818) 846-0797
- Fax
- (818) 846-0440
- NPI assigned
- Dec 24, 2006
- 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 | PSY 5344 | CA | Primary |
Addresses
Primary practice location
421 E Angeleno Ave
Suite 205
Burbank, CA 91501-2286
Mailing address
421 E Angeleno Ave
Suite 205
Burbank, CA 91501-2286
Phone (818) 846-0797
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2019 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 5344 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yaniv Jay Dvora Chiropractic Corp | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Simi Valley, CA
- NPI 1053678912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1164587846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 E ANGELENO AVE",
"address_2": "SUITE 205",
"city": "BURBANK",
"state": "CA",
"postal_code": "915012286",
"telephone_number": "818-846-0797",
"fax_number": "818-846-0440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 E ANGELENO AVE",
"address_2": "SUITE 205",
"city": "BURBANK",
"state": "CA",
"postal_code": "915012286",
"telephone_number": "818-846-0797",
"fax_number": "818-846-0440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DASH",
"first_name": "JERRY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-24",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 5344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.