Individual provider Active NPI

Elizabeth H Cleary, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1528295912
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
26686 Issued in CA
Practice address
UCLA Simms Mann 200 Medical Plaza Suite 502
Los Angeles, CA 90095-0001
Phone
(310) 794-6644
NPI assigned
Jun 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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 26686 CA Primary

Addresses

Primary practice location

UCLA Simms Mann 200 Medical Plaza Suite 502
Los Angeles, CA 90095-0001

Mailing address

UCLA Simms/Mann 200 Medical Plaza Suite 502
Los Angeles, CA 90095-7228
Phone (310) 794-6644

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
26686CAMDClinical Psychologist
40016TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1528295912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCLA SIMMS/MANN 200 MEDICAL PLAZA SUITE 502",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957228",
            "telephone_number": "310-794-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA SIMMS MANN 200 MEDICAL PLAZA SUITE 502",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-794-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "ELIZABETH",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "26686",
            "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 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.