Edward De Anda, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

33988 Issued in CA

Practice address

136 N Chester Ave
Pasadena, CA 91106-1805

Phone

(619) 754-1928

NPI assigned

Sep 30, 2019

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Psychology Task Force Corp

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1740973791
  NPD Authorized official
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychologist

  NPD

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1497396527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 N CHESTER AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061805",
            "telephone_number": "619-754-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N CHESTER AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061805",
            "telephone_number": "619-754-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ANDA",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92-2323219",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Day, PHARM.D.
• Sharie Day
• Parvaneh Dayani, L.AC
• Diana Garcia De Alba, LMFT
• Amy De Anda
• Katheryn Elizabeth De Arakal
• Rhiannon Megan De Carlo, MFT
• Jocelyn Pestanas De Castro, RN
• Jocelynne Estandian De Castro, RN
• Ma Sofia B De Castro, P.T.

• Clinical Psychologist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.

Verify at the official NPI Registry.