Individual provider Active NPI

Kholud Noor Helou, MFT, PSY.D.

  • Psychologist
  • San Dimas, CA
National Provider Identifier
1407953474
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY23698 Issued in CA
Practice address
1305 W Arrow Hwy
Ste 204
San Dimas, CA 91773-2338
Phone
(909) 482-4444
NPI assigned
Sep 20, 2006
Last updated
Oct 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY23698 CA Primary
Marriage & Family Therapist 106H00000X MFC38277 CA

Addresses

Primary practice location

1305 W Arrow Hwy
Ste 204
San Dimas, CA 91773-2338

Mailing address

1305 W Arrow Hwy
Ste 204
San Dimas, CA 91773-2338
Phone (909) 482-4444

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY23698CAMDPsychologist
MFC38277CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Helou Psychological Services Inc CurrentSince Jul 27, 2020 Accepting new patients

Locations

1305 W Arrow Hwy
Ste 204
San Dimas, CA 91773
Phone (626) 780-1061

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1407953474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W ARROW HWY",
            "address_2": "STE 204",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732338",
            "telephone_number": "909-482-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W ARROW HWY",
            "address_2": "STE 204",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732338",
            "telephone_number": "909-482-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELOU",
        "first_name": "KHOLUD",
        "middle_name": "NOOR",
        "credential": "MFT, PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY23698",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC38277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.