Individual provider Active NPI

Soumita Sen, PSY. D

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1447667472
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32220 Issued in CA
Practice address
1031 W 34TH St Ste 500
Los Angeles, CA 90089-3687
Phone
(213) 821-6500
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Case Manager/Care Coordinator 171M00000X
Rehabilitation Counselor 225C00000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY32220 CA Primary

Addresses

Primary practice location

1031 W 34TH St Ste 500
Los Angeles, CA 90089-3687

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Other practice location 1

1730 W Olympic Blvd # 3A-300
Los Angeles, CA 90015-1019
Phone (213) 249-9388

Other practice location 2

902 S Myrtle Ave
Monrovia, CA 91016
Phone (626) 357-3258

Other practice location 3

11741 Telegraph Rd Ste G
Santa Fe Springs, CA 90670-3687
Phone (626) 701-0534

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
I20210616002250 CA Practitioner - Clinical Psychologist 6800296526 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY32220CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2022 Accepting new patients
Soultenders Psychological Services, Inc. CurrentSince Jul 1, 2026 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

2999 Overland Ave
Ste 209
Los Angeles, CA 90064
Phone (310) 893-6979

1031 W 34th St
Ste 500
Los Angeles, CA 90089
Phone (213) 764-2800

Organizations & group practices 4

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1447667472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 W 34TH ST STE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900893687",
            "telephone_number": "213-821-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 W Olympic Blvd # 3A-300",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900151019",
            "country_code": "US",
            "telephone_number": "213-249-9388",
            "fax_number": "213-389-7993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 S Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Monrovia",
            "state": "CA",
            "postal_code": "91016",
            "country_code": "US",
            "telephone_number": "626-357-3258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11741 Telegraph Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "Santa Fe Springs",
            "state": "CA",
            "postal_code": "906703687",
            "country_code": "US",
            "telephone_number": "626-701-0534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEN",
        "first_name": "SOUMITA",
        "name_prefix": "Dr.",
        "credential": "PSY. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.