Individual provider Active NPI

Joan Gabrielle Freedman, PH.D.

  • Clinical Psychologist
  • Beverly Hills, CA
National Provider Identifier
1285754200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13683 Issued in CA
Practice address
9615 Brighton Way
Suite 420
Beverly Hills, CA 90210-5131
Phone
(310) 858-8836
NPI assigned
Mar 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY13683 CA Primary

Addresses

Primary practice location

9615 Brighton Way
Suite 420
Beverly Hills, CA 90210-5131

Mailing address

9615 Brighton Way
Suite 420
Beverly Hills, CA 90210-5131
Phone (310) 858-8836

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000809 CA Practitioner - Clinical Psychologist 2961663372 Practice locations: Beverly Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9615 Brighton Way
Suite 420
Beverly Hills, CA 90210-5118
Phone (310) 858-8836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13683CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285754200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY",
            "address_2": "SUITE 420",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105131",
            "telephone_number": "310-858-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY",
            "address_2": "SUITE 420",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105131",
            "telephone_number": "310-858-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "JOAN",
        "middle_name": "GABRIELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.