Individual provider Active NPI

Glenda Jean Corstorphine

  • Psychoanalyst
  • Pasadena, CA
National Provider Identifier
1225799604
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
MFC27747 Issued in CA
Practice address
595 E Colorado Blvd Ste 318
Pasadena, CA 91101-2021
Phone
(626) 449-9927
NPI assigned
Jan 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC27747 CA
PsychoanalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 102L00000X MFC27747 CA Primary

Addresses

Primary practice location

595 E Colorado Blvd Ste 318
Pasadena, CA 91101-2021

Mailing address

595 E Colorado Blvd Ste 318
Pasadena, CA 91101-2021
Phone (626) 449-9927

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL glendacorstorphinepsyd.com Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC27747CAMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1225799604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD STE 318",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012021",
            "telephone_number": "626-449-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD STE 318",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012021",
            "telephone_number": "626-449-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSTORPHINE",
        "first_name": "GLENDA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC27747",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "CA",
            "license": "MFC27747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "glendacorstorphinepsyd.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "595 E Colorado Blvd Ste 318",
            "city": "Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "911012021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.