Individual provider Active NPI

Anne Khalifeh, PSY.D., ABPP

  • Clinical Psychologist
  • Aurora, CO
National Provider Identifier
1174664627
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3852 Issued in CO
Practice address
11059 E. Bethany Drive
Aurora, CO 80014
Phone
(303) 617-2300
Fax
(303) 617-2365
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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 3852 CO Primary

Addresses

Primary practice location

11059 E. Bethany Drive
Aurora, CO 80014

Mailing address

11059 E. Bethany Drive
Aurora, CO 80014
Phone (303) 617-2300

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

State licenses

LicenseStateTypeSpecialty
3852COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Wu MD PHD Inc CurrentSince Jul 1, 2021 Accepting new patients
Robert Zalewski-Zaragoza, MD, Inc Past Accepting new patients
Siyan Clinical Corporation PastSince Feb 15, 2014 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

16890 Green Tree Blvd
Victorville, CA 92395
Phone (310) 273-4843

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1174664627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11059 E. BETHANY DRIVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80014",
            "telephone_number": "303-617-2300",
            "fax_number": "303-617-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11059 E. BETHANY DRIVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80014",
            "telephone_number": "303-617-2300",
            "fax_number": "303-617-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIFEH",
        "first_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., ABPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.