Active NPI
Andrea Benkle Ackerman, PH.D.
- Clinical Psychologist
- Woodland Hills, CA
National Provider Identifier
1467523654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY6800
- Practice address
- 21731 Ventura Blvd Ste 160
Woodland Hills, CA 91364-5109 - Phone
- (818) 713-1006
- NPI assigned
- Nov 11, 2006
- Last updated
- Oct 10, 2017
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY6800 | CA | Primary |
Addresses
Primary practice location
21731 Ventura Blvd Ste 160
Woodland Hills, CA 91364-5109
Mailing address
5438 Lubao Ave
Woodland Hills, CA 91364-2607
Phone (818) 713-1006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2018 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY6800 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507593600000",
"number": "1467523654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5438 LUBAO AVE",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913642607",
"telephone_number": "818-713-1006",
"fax_number": "818-713-1107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21731 VENTURA BLVD STE 160",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913645109",
"telephone_number": "818-713-1006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERMAN",
"first_name": "ANDREA",
"middle_name": "BENKLE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-11",
"last_updated": "2017-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY6800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.