Individual provider Active NPI

Parul Patel

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1396934204
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22223 Issued in CA
Practice address
605 W Olympic Blvd Ste 600
Los Angeles, CA 90015-1475
Phone
(213) 553-1884
Fax
(213) 236-9662
NPI assigned
Oct 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22223 CA Primary

Addresses

Primary practice location

605 W Olympic Blvd Ste 600
Los Angeles, CA 90015-1475

Mailing address

4929 Wilshire Blvd Ste 510
Los Angeles, CA 90010-3820
Phone (562) 904-3999

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090720000306 CA Practitioner - Clinical Psychologist 7315099520 Practice locations: Tustin, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14751 Plaza Dr
Suite C
Tustin, CA 92780-2773
Phone (310) 560-1271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY22223CAMDClinical Psychologist
22223CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vericare of California Medical Group Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1396934204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 WILSHIRE BLVD STE 510",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103820",
            "telephone_number": "562-904-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W OLYMPIC BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151475",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PARUL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.