Active NPI
Lawrence Peskin, PSY.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1477004794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY28318
- Practice address
- 10114 Empyrean Way
Apt. 204
Los Angeles, CA 90067-3830 - Phone
- (440) 281-7271
- NPI assigned
- Oct 21, 2016
- Last updated
- Oct 21, 2016
- Sex
- Male
- 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 | PSY28318 | CA | Primary |
Addresses
Primary practice location
10114 Empyrean Way
Apt. 204
Los Angeles, CA 90067-3830
Mailing address
10114 Empyrean Way
Apt. 204
Los Angeles, CA 90067-3830
Phone (440) 281-7271
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- lawrence.peskin.1@28394.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1477004794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10114 EMPYREAN WAY",
"address_2": "APT. 204",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900673830",
"telephone_number": "440-281-7271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10114 EMPYREAN WAY",
"address_2": "APT. 204",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900673830",
"telephone_number": "440-281-7271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESKIN",
"first_name": "LAWRENCE",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-21",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY28318",
"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 Oct 21, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.