Individual provider Active NPI

Dana Kiesel, PHD

  • Clinical Psychologist
  • Beverly Hills, CA
National Provider Identifier
1174745756
Registry record updated Feb 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12664 Issued in CA
Practice address
435 N Bedford Dr Ste 311
Beverly Hills, CA 90210-4347
Phone
(310) 273-8537
Fax
(310) 273-7556
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 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 PSY12664 CA Primary

Addresses

Primary practice location

435 N Bedford Dr Ste 311
Beverly Hills, CA 90210-4347

Mailing address

626 N Sierra Dr
Beverly Hills, CA 90210-3522
Phone (310) 273-8537

Other names 1

  • Miss Dana Caryl Friedman Other name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091222000404 CA Practitioner - Clinical Psychologist 3678613791 Practice locations: Beverly Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

435 N Bedford Dr
Suite 311
Beverly Hills, CA 90210-4347
Phone (310) 273-8537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12664CAMDClinical Psychologist
12664CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707609600000",
    "number": "1174745756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N SIERRA DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103522",
            "telephone_number": "310-273-8537",
            "fax_number": "310-273-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N BEDFORD DR STE 311",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104347",
            "telephone_number": "310-273-8537",
            "fax_number": "310-273-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESEL",
        "first_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-02-11",
        "certification_date": "2024-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "FRIEDMAN",
            "middle_name": "CARYL",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.