Irene S Fruchtbaum, PH.D., Q.M.E.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY18821 Issued in CA

Practice address

22231 Mulholland Hwy
Suite 106
Calabasas, CA 91302-5123

Phone

(818) 222-9300

Fax

(818) 223-8224

NPI assigned

May 25, 2013

Last updated

Mar 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Irene S. Fruchtbaum, PH.D., Q.M.E.

  • Group Psychotherapy Psychologist
  • Agoura Hills, CA
  • NPI 1447010053
  NPD Authorized official
• Change Within Reach Inc

  • Adult Mental Health Clinic/Center
  • Encino, CA
  • NPI 1003207002
  Medicare reassignment

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

{
    "created_epoch": "1369440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1386081743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4117",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913084117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22231 MULHOLLAND HWY",
            "address_2": "SUITE 106",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913025123",
            "telephone_number": "818-222-9300",
            "fax_number": "818-223-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUCHTBAUM",
        "first_name": "IRENE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D., Q.M.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-25",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Frazier
• Lauren Freedman
• Sarita Freedman, PH.D.
• Emily Friefeld, PSYD
• Madeleine Friendly
• Therese Ott Funk
• Debra Erin Furie-Smuckler, MA, MFT
• Carla G Galan
• Youlia Galenko
• Serena Taylor Galindo

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.