Jon-Patrik Pedersen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY11837 Issued in CA

Practice address

102 N Madison Ave
Pasadena, CA 91101-1710

Phone

(626) 449-4737

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 13, 2026 through Feb 13, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jon-Patrik Pedersen, PHD, Clinical Psychology P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pasadena, CA
  • NPI 1225953490
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376695635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N MADISON AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011710",
            "telephone_number": "626-449-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N MADISON AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011710",
            "telephone_number": "626-449-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JON-PATRIK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmin Tajanee Pearson
• Philip Gair Pearson, M.D.
• Seanny Pech
• Amelia Frances Peck
• Edwin Cady Peck III, MD
• Pediatric Orthotic and Prosthetic Services-West,LLC
• Nelun Pedris, OD
• Eduardo Pedro
• Giovanna Pegolo, M.D.
• Pei C Vuong Chiropractor a Professional Corp

• Clinical Psychologist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.