Express Healthcare LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

EXPRESS HEALTHCARE LLC

Practice address

21839 Saddle Peak Road
Topanga, CA 90290

Phone

(668) 866-1466

NPI assigned

Sep 4, 2020

Organization subpart

No

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

Authorized official

Name

Paul Brooks

Title

President

Phone

(866) 866-1466

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1356955595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14320 VENTURA BLVD # 434",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232717",
            "telephone_number": "668-866-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21839 SADDLE PEAK ROAD",
            "city": "TOPANGA",
            "state": "CA",
            "postal_code": "90290",
            "telephone_number": "668-866-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-866-1466"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EIN",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbrooks@psctechnologyinc.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email Address",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email Address",
            "address_1": "14320 Ventura Blvd # 434",
            "city": "Sherman Oaks",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914232717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.