Pardis Bolandian, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 24206 Issued in CA

Practice address

19725 Sherman Way
Winnetka, CA 91306-3650

Phone

(310) 247-8712

NPI assigned

Jan 19, 2017

Last updated

Dec 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Pardis Bolandian-Allen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1306383062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11838 KIOWA AVE APT 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496020",
            "telephone_number": "310-266-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19725 SHERMAN WAY",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913063650",
            "telephone_number": "310-247-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANDIAN",
        "first_name": "PARDIS",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 24206",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1829726",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF APPLIED BEHAVIOR ANALYSIS",
            "identifier": "11829726",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PARDIS",
            "last_name": "BOLANDIAN-ALLEN",
            "prefix": "DR.",
            "credential": "BCBA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Psychologist in Winnetka, CA
• Providers in Winnetka, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.