Kimberly Hagen Hagen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

16798 Issued in CA

Practice address

12021 Wilmington Ave
Trailer 6
Los Angeles, CA 90059-3019

Phone

(310) 668-6428

NPI assigned

Mar 5, 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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1780877613
  Medicare reassignment

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245369990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CORPORATE POINTE",
            "address_2": "SUITE 300",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307615",
            "telephone_number": "310-625-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "address_2": "TRAILER 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "310-668-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "KIMBERLY",
        "middle_name": "HAGEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "16798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reem Hage Hassan
• Sally Anne Hageman
• John Hagen
• Kaitlin Lee Hagen, LMFT
• Kate Hagen, MD
• Meryl Irene Haviva Haggege, MA, LMFT
• Marni Rae Haggstrom, LCSW
• Ashkan Haghani
• Arshan Haghi, D.M.D
• Bardya Haghighat, DO

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.