James Peck, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY19076 Issued in CA

Practice address

2730 Wilshire Blvd Ste 550
Santa Monica, CA 90403-4748

Phone

(310) 279-2976

Fax

(310) 828-7311

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2014 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Susan T Henderson

  • Clinical Social Worker
  • Santa Monica, CA
  • NPI 1548324304
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1467568170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD STE 550",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034748",
            "telephone_number": "310-279-2976",
            "fax_number": "310-828-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD STE 550",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034748",
            "telephone_number": "310-279-2976",
            "fax_number": "310-828-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "PSY190760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martin Pearlman
• Casey Pearson-Gottlieb
• Peb LLC
• Brian Peck, DC
• Haley Peck, LCSW
• Rebecca Pedras
• Elisabeth M Peffley, N.M.D,L.AC
• Taksina Pelaez
• Peter C Pelikan, M.D.
• Pelvica Physical Therapy, Inc.

• Psychologist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.

Verify at the official NPI Registry.