Individual provider Active NPI

Marco Fekrat, PSY.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1467618801
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
30209 Issued in CA
Practice address
7135 Hollywood Blvd Apt 1205
Los Angeles, CA 90046-3251
Phone
(424) 333-0134
NPI assigned
Aug 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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 30209 CA Primary

Addresses

Primary practice location

7135 Hollywood Blvd Apt 1205
Los Angeles, CA 90046-3251

Mailing address

7135 Hollywood Blvd Apt 1205
Los Angeles, CA 90046-3251
Phone (424) 333-0134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30209CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Marco Fekrat Psychological Services Clinical CurrentSince May 12, 2024 Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients

Organizations & group practices 2

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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1467618801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7135 HOLLYWOOD BLVD APT 1205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900463251",
            "telephone_number": "424-333-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7135 HOLLYWOOD BLVD APT 1205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900463251",
            "telephone_number": "424-333-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEKRAT",
        "first_name": "MARCO",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2024-05-06",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.