NPIMap

Organization Active NPI

Evolving Pathways Psychology Corporation

  • Clinical Psychologist
  • Hermosa Beach, CA
National Provider Identifier
1194303446
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
EVOLVING PATHWAYS PSYCHOLOGY CORPORATION
Practice address
2447 Pacific Coast Hwy Ste 210
Hermosa Beach, CA 90254-2714
Phone
(310) 905-3151
Fax
(310) 756-1225
NPI assigned
Mar 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Dr. Jessie Caldera, PSY.DNPI 1497005706
Title
Clinical Psychologist
Phone
(424) 212-3212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2447 Pacific Coast Hwy Ste 210
Hermosa Beach, CA 90254-2714

Mailing address

2447 Pacific Coast Hwy Ste 210
Hermosa Beach, CA 90254-2714
Phone (310) 905-3151

Other practice location 1

473 E Carnegie Dr
Ste 200
San Bernardicno, CA 92408
Phone (310) 905-3151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210914003366 CA Part B Supplier - Clinic/Group Practice 6002212115 Receives reassigned benefits from 8 practitioners
Practice locations: Hermosa Beach, CA; San Bernardino, CA

National Provider Directory

National Provider Directory

Locations

2447 Pacific Coast Hwy
Ste 210
Hermosa Beach, CA 90254
Phone (310) 905-3151

2447 Pacific Coast Hwy
#210
Hermosa Beach, CA 90254
Phone (424) 212-3212

6520 West Blvd
Los Angeles, CA 90043
Phone (323) 753-1354

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1194303446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2447 PACIFIC COAST HWY STE 210",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542714",
            "telephone_number": "310-905-3151",
            "fax_number": "310-756-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 PACIFIC COAST HWY STE 210",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542714",
            "telephone_number": "310-905-3151",
            "fax_number": "310-756-1225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "473 E Carnegie Dr",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Bernardicno",
            "state": "CA",
            "postal_code": "92408",
            "country_code": "US",
            "telephone_number": "310-905-3151",
            "fax_number": "310-756-1225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVING PATHWAYS PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "CALDERA",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "424-212-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermosa Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.