Individual provider Active NPI

Linda K O'Dell, PH.D.

  • Clinical Psychologist
  • Santa Monica, CA
National Provider Identifier
1477989846
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25831 Issued in CA
Practice address
100 Wilshire Blvd Ste 700
Santa Monica, CA 90401-3602
Phone
(661) 619-7889
Fax
(310) 579-8467
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 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 PSY25831 CA Primary

Addresses

Primary practice location

100 Wilshire Blvd Ste 700
Santa Monica, CA 90401-3602

Mailing address

15404 Russell Rd
Chagrin Falls, OH 44022-2665
Phone (661) 619-7889

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
I20140107000951 CA Practitioner - Clinical Psychologist 1355579830 Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Wilshire Blvd
Suite 700
Santa Monica, CA 90401-3602
Phone (661) 619-7889

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY25831CAMDPsychologist
25831CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1477989846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15404 RUSSELL RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440222665",
            "telephone_number": "661-619-7889",
            "fax_number": "310-579-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILSHIRE BLVD STE 700",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904013602",
            "telephone_number": "661-619-7889",
            "fax_number": "310-579-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "LINDA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.