Active NPI
Shirley Pakdaman
- Psychologist
- Beverly Hills, CA
National Provider Identifier
1437515053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 26413
- Practice address
- 9730 Wilshire Blvd
Ste 205a
Beverly Hills, CA 90212-2004 - Phone
- (310) 431-9866
- NPI assigned
- Jan 12, 2016
- Last updated
- Sep 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 26413 | CA | Primary |
Addresses
Primary practice location
9730 Wilshire Blvd
Ste 205a
Beverly Hills, CA 90212-2004
Mailing address
9730 Wilshire Blvd
Ste 205a
Beverly Hills, CA 90212-2004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2020 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26413 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ryan Janis PSYD Inc | Psychologist | 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, 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": "1452556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473292800000",
"number": "1437515053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9730 WILSHIRE BLVD",
"address_2": "STE 205A",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902122004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9730 WILSHIRE BLVD",
"address_2": "STE 205A",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902122004",
"telephone_number": "310-431-9866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAKDAMAN",
"first_name": "SHIRLEY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-12",
"last_updated": "2016-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "26413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.