Nicholas Keith Bennett, PSYD

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY33288 Issued in CA

Practice address

1301 N Broadway Ste 32424
Los Angeles, CA 90012-1408

Phone

(805) 225-4446

Fax

(805) 273-0206

NPI assigned

Mar 15, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Other names 1

• Dr. Nicholas Bennett Gonzalez Former name

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

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.

• Redwood Psychology Center, Inc

  • Group Psychotherapy Psychologist
  • Monte Rio, CA
  • NPI 1629196290
  Medicare reassignment NPD
• Weekend Therapy Psychological Services, Inc.

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1003695362

  Mental Health

  NPD Authorized official
• Pasadena Clinical Group, a Psychology Corporation

  • Psychologist
  • Pasadena, CA
  • NPI 1790213247
  NPD (past)
• Redwood Psychology Center, Inc.

  • Group Psychotherapy Psychologist
  • Monte Rio, CA
  • NPI 1902243330
  NPD (past)
• Western Pacific Psychological Network, Inc

  • Clinical Psychologist
  • Sherman Oaks, CA
  • NPI 1659621480
  NPD (past)

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1508325903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N BROADWAY STE 32424",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121408",
            "telephone_number": "805-225-4446",
            "fax_number": "805-273-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N BROADWAY STE 32424",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121408",
            "telephone_number": "805-225-4446",
            "fax_number": "805-273-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "NICHOLAS",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-15",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33288",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006612",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY33288",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "1336",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33288",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY33288",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY33288",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0006612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLAS",
            "last_name": "GONZALEZ",
            "middle_name": "BENNETT",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karla Bennett, LCSW
• Lauren Marie Bennett, NP-C
• LC Bennett
• Michael Luis Bennett
• Michaelyn Bennett
• Nicole Bennett, MS
• Rebie Latoya Bennett, FNP-C
• Sharma Bennett, MFT
• Vincent J Bennett, MD
• Wayne M Bennett

• Forensic Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.