Miriam Elizabeth Lewis Hall, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY16759 Issued in CA

Practice address

12625 La Mirada Blvd
Suite 202
La Mirada, CA 90638-2211

Phone

(562) 903-4800

Fax

(562) 903-4864

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2017 through Oct 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Biola Counseling Center

  • Clinical Psychologist
  • La Mirada, CA
  • NPI 1255547378
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184846164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 LA MIRADA BLVD",
            "address_2": "SUITE 202",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382211",
            "telephone_number": "562-903-4800",
            "fax_number": "562-903-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 LA MIRADA BLVD",
            "address_2": "SUITE 202",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382211",
            "telephone_number": "562-903-4800",
            "fax_number": "562-903-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MIRIAM",
        "middle_name": "ELIZABETH LEWIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Renee Green, LPCC
• Jessica Amparo Guerrero
• Ruby Guillen
• Louie Martin Gunderson
• Tae Kyun Ha, DDS
• Sarah Hall, RD, IBCLC
• Todd W Hall, PHD
• Aaron James Hamilton, D.C.
• Sharon Han, DDS
• Harbor Healthcare Inc

• Clinical Psychologist in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.