Active NPI
Elena Konstat, PH.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1528262003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 11472
- Practice address
- 4929 Wilshire Blvd Ste 413
Los Angeles, CA 90010-3816 - Phone
- (323) 651-2194
- Fax
- (323) 651-2094
- NPI assigned
- Jun 11, 2007
- Sex
- Female
- 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 | PSY 11472 | CA | Primary |
Addresses
Primary practice location
4929 Wilshire Blvd Ste 413
Los Angeles, CA 90010-3816
Mailing address
4929 Wilshire Blvd Ste 413
Los Angeles, CA 90010-3816
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 11472 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528262003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4929 WILSHIRE BLVD STE 413",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4929 WILSHIRE BLVD STE 413",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103816",
"telephone_number": "323-651-2194",
"fax_number": "323-651-2094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONSTAT",
"first_name": "ELENA",
"name_prefix": "Ms.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 11472",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.