Individual provider Active NPI

Rochelle Marie Reno, PH.D.

  • Clinical Psychologist
  • Santa Monica, CA
National Provider Identifier
1467535997
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY7528 Issued in CA
Practice address
3201 Wilshire Blvd Ste 201
Santa Monica, CA 90403-2337
Phone
(310) 774-6104
Fax
(310) 693-8106
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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 PSY7528 CA Primary

Addresses

Primary practice location

3201 Wilshire Blvd Ste 201
Santa Monica, CA 90403-2337

Mailing address

1741 Colby Ave
#203
Los Angeles, CA 90025-4187
Phone (310) 479-3490

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
I20070731000298 CA Practitioner - Clinical Psychologist 7416058771 Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3201 Wilshire Blvd
Suite 201
Santa Monica, CA 90403-2337
Phone (310) 774-6104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY7528CAMDClinical Psychologist
7528CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
The Reno Trust Dated November 8, 2007 Clinical CurrentSince Sep 11, 2022 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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1467535997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 COLBY AVE",
            "address_2": "#203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254187",
            "telephone_number": "310-479-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 WILSHIRE BLVD STE 201",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032337",
            "telephone_number": "310-774-6104",
            "fax_number": "310-693-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENO",
        "first_name": "ROCHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY7528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.