Individual provider Active NPI

Kathi N. Magnussen, PHD.

  • Psychologist
  • Beverly Hills, CA
National Provider Identifier
1306999495
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY10956 Issued in CA
Practice address
9615 Brighton Way
424
Beverly Hills, CA 90210-5131
Phone
(310) 288-0917
Fax
(310) 288-0917
NPI assigned
Jan 19, 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
Psychologist 103T00000X PSY10956 CA Primary

Addresses

Primary practice location

9615 Brighton Way
424
Beverly Hills, CA 90210-5131

Mailing address

9615 Brighton Way
424
Beverly Hills, CA 90210-5131
Phone (310) 288-0917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 2, 2018 through Jan 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10956CAMDAddiction (Substance Use Disorder) Counselor
PSY10956CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306999495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY",
            "address_2": "424",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105131",
            "telephone_number": "310-288-0917",
            "fax_number": "310-288-0917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 BRIGHTON WAY",
            "address_2": "424",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105131",
            "telephone_number": "310-288-0917",
            "fax_number": "310-288-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSSEN",
        "first_name": "KATHI",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY10956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.