Active NPI
Brian Jacob Benjamin, PSY.D.
- Clinical Psychologist
- Pasadena, CA
National Provider Identifier
1316449176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 30900
- Practice address
- 200 E del Mar Blvd Ste 206
Pasadena, CA 91105-2552 - Phone
- (626) 808-4136
- NPI assigned
- Mar 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 30900 | CA | Primary |
Addresses
Primary practice location
200 E del Mar Blvd Ste 206
Pasadena, CA 91105-2552
Mailing address
200 E del Mar Blvd Ste 206
Pasadena, CA 91105-2552
Phone (626) 808-4136
Other practice location 1
11331 Ventura Blvd Ste 1D
Studio City, CA 91604-3147
Phone (818) 762-5560
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30900 | CA | MD | General Care Certified Respiratory Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perri W Johnson, Psychology Inc | Clinical | Past | Accepting new patients |
| The Center for Neurotherapy | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Center for Neurotherapy
- Clinical Psychologist
- Studio City, CA
- NPI 1861737876
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1518130905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561248000000",
"number": "1316449176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E DEL MAR BLVD STE 206",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052552",
"telephone_number": "626-808-4136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E DEL MAR BLVD STE 206",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052552",
"telephone_number": "626-808-4136"
}
],
"practiceLocations": [
{
"address_1": "11331 Ventura Blvd Ste 1D",
"address_purpose": "LOCATION",
"city": "Studio City",
"state": "CA",
"postal_code": "916043147",
"country_code": "US",
"telephone_number": "818-762-5560",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENJAMIN",
"first_name": "BRIAN",
"middle_name": "JACOB",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-07",
"last_updated": "2019-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "30900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.