Organization Active NPI

Association of Behavioral Health Specialists

  • Clinical Psychologist
  • Van Nuys, CA
National Provider Identifier
1306132790
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 21815 Issued in CA
Legal business name
ASSOCIATION OF BEHAVIORAL HEALTH SPECIALISTS
Practice address
6454 Van Nuys Blvd
Suite 111
Van Nuys, CA 91401-1445
Phone
(818) 336-6441
Fax
(818) 336-6441
NPI assigned
Jun 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Authorized official

Name
Dr. Jose Corena, PSY.DNPI 1659557965
Title
Owner
Phone
(818) 336-6441

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: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY 21815 CA Primary

Addresses

Primary practice location

6454 Van Nuys Blvd
Suite 111
Van Nuys, CA 91401-1445

Mailing address

6454 Van Nuys Blvd
Suite 111
Van Nuys, CA 91401-1445
Phone (818) 336-6441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111018000332 CA Part B Supplier - Clinic/Group Practice 3678745684 Receives reassigned benefits from 1 practitioner
Practice locations: Van Nuys, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1306132790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6454 VAN NUYS BLVD",
            "address_2": "SUITE 111",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011445",
            "telephone_number": "818-336-6441",
            "fax_number": "818-336-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6454 VAN NUYS BLVD",
            "address_2": "SUITE 111",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011445",
            "telephone_number": "818-336-6441",
            "fax_number": "818-336-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATION OF BEHAVIORAL HEALTH SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "CORENA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-336-6441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 21815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.