Individual provider Active NPI

Nina Tepper, PHD

  • Clinical Child & Adolescent Psychologist
  • Los Angeles, CA
National Provider Identifier
1356883060
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY16480 Issued in CA
Practice address
10323 Santa Monica Blvd
Suite 111
Los Angeles, CA 90025-6071
Phone
(310) 918-3834
NPI assigned
Nov 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY16480 CA Primary

Addresses

Primary practice location

10323 Santa Monica Blvd
Suite 111
Los Angeles, CA 90025-6071

Mailing address

10323 Santa Monica Blvd
Suite 111
Los Angeles, CA 90025-6071
Phone (310) 918-3834

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16480CAMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1356883060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10323 SANTA MONICA BLVD",
            "address_2": "SUITE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256071",
            "telephone_number": "310-918-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10323 SANTA MONICA BLVD",
            "address_2": "SUITE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256071",
            "telephone_number": "310-918-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPPER",
        "first_name": "NINA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY16480",
            "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 Nov 11, 2016; 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.