Individual provider Active NPI

Dawn Tennenbaum, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1437500857
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32107 Issued in CA
Practice address
627 N Larchmont Blvd
Los Angeles, CA 90004-1307
Phone
(424) 422-1010
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 PSY32107 CA Primary

Addresses

Primary practice location

627 N Larchmont Blvd
Los Angeles, CA 90004-1307

Mailing address

627 N Larchmont Blvd
Los Angeles, CA 90004-1307
Phone (424) 422-1010

Other names 1

  • Dawn Glover Former name

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY32107CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dawn Tennenbaum, Psychological Corporation Current 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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1437500857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041307",
            "telephone_number": "424-422-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 N LARCHMONT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900041307",
            "telephone_number": "424-422-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNENBAUM",
        "first_name": "DAWN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "GLOVER",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.