Active NPI
Ellen Basian, PH.D.
- Psychologist
- Los Angeles, CA
National Provider Identifier
1356540405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY14499
- Practice address
- 10780 Santa Monica Blvd
Ste 250
Los Angeles, CA 90025-4777 - Phone
- (310) 262-4026
- Fax
- (310) 475-0106
- NPI assigned
- Jul 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY14499 | CA | Primary |
Addresses
Primary practice location
10780 Santa Monica Blvd
Ste 250
Los Angeles, CA 90025-4777
Mailing address
10780 Santa Monica Blvd
Ste 250
Los Angeles, CA 90025-4777
Phone (310) 262-4026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483574400000",
"number": "1356540405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10780 SANTA MONICA BLVD",
"address_2": "STE 250",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900254777",
"telephone_number": "310-262-4026",
"fax_number": "310-475-0106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10780 SANTA MONICA BLVD",
"address_2": "STE 250",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900254777",
"telephone_number": "310-262-4026",
"fax_number": "310-475-0106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASIAN",
"first_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-17",
"last_updated": "2017-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY14499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.