Eleni Bagourdi, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22542 Issued in CA

Practice address

2001 S Barrington Ave Ste 314
Los Angeles, CA 90025-5379

Phone

(310) 999-9683

Fax

(213) 261-9887

NPI assigned

Feb 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Elena Bagourdi Professional name

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, 2007

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Elderly Behavioral Wellness Services IncGroup PAC ID 4082934880, 2 clinicians

Eb Psychotherapy, IncGroup PAC ID 8527107705, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Eb Psychotherapy, Inc

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1699009753
  Medicare reassignment Care Compare group NPD Authorized official
• Elderly Behavioral Wellness Services Inc

  • Adult Development & Aging Psychologist
  • Los Angeles, CA
  • NPI 1871983106
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1447490958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE STE 314",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255379",
            "telephone_number": "310-999-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE STE 314",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255379",
            "telephone_number": "310-999-9683",
            "fax_number": "213-261-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGOURDI",
        "first_name": "ELENI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "BAGOURDI",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John Fitzgerald Bagnerise
• Dahlia Bagnis
• Valerie Ledith Bagnol, MSW
• Gabriel Bagon
• Elaine M Bagorio
• Arpine Bagramyan
• Anju Bagrodia
• Caroline Bagshaw, DVM
• Janice Bagsic
• David B Bagtas Jr., NP

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.