Individual provider Active NPI

Molly Mechammil Samaan

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1285259051
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
33762 Issued in CA
Practice address
11900 W Olympic Blvd Ste 410
Los Angeles, CA 90064-1168
Phone
(888) 225-1995
NPI assigned
Jun 8, 2020
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 33762 CA Primary

Addresses

Primary practice location

11900 W Olympic Blvd Ste 410
Los Angeles, CA 90064-1168

Mailing address

11900 W Olympic Blvd Ste 410
Los Angeles, CA 90064-1168
Phone (888) 225-1995

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
33762CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1285259051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 W OLYMPIC BLVD STE 410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641168",
            "telephone_number": "888-225-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 W OLYMPIC BLVD STE 410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641168",
            "telephone_number": "888-225-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAAN",
        "first_name": "MOLLY",
        "middle_name": "MECHAMMIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "33762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.