Active NPI
Jennifer Levine, PSY.D.
- Clinical Psychologist
- Encino, CA
National Provider Identifier
1164588208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY20579
- Practice address
- 16055 Ventura Blvd
Suite 1033
Encino, CA 91436-2601 - Phone
- (310) 499-7070
- Fax
- (810) 815-7070
- NPI assigned
- Dec 30, 2006
- Sex
- Female
- 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 | PSY20579 | CA | Primary |
Addresses
Primary practice location
16055 Ventura Blvd
Suite 1033
Encino, CA 91436-2601
Mailing address
5627 Kanan Rd Ste 157
Agoura Hills, CA 91301-3358
Phone (310) 499-7070
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080103000753 | CA | Practitioner - Clinical Psychologist | 1658451505 | Practice locations: Oak Park, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2003
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5627 Kanan Rd
Suite 157
Agoura Hills, CA 91301-3358
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY20579 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651104000000",
"number": "1164588208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5627 KANAN RD STE 157",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "913013358",
"telephone_number": "310-499-7070",
"fax_number": "810-815-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16055 VENTURA BLVD",
"address_2": "SUITE 1033",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362601",
"telephone_number": "310-499-7070",
"fax_number": "810-815-7070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "JENNIFER",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-30",
"last_updated": "2022-04-28",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY20579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.