Individual provider Active NPI

Sheryl Mandela Eden, PSYD

  • Psychologist
  • Encino, CA
National Provider Identifier
1538302807
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 16338 Issued in CA
Practice address
5535 Balboa Blvd
Suite 202
Encino, CA 91316-1516
Phone
(818) 468-5599
NPI assigned
Apr 15, 2009
Last updated
Apr 15, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 16338 CA Primary

Addresses

Primary practice location

5535 Balboa Blvd
Suite 202
Encino, CA 91316-1516

Mailing address

5535 Balboa Blvd
Suite 202
Encino, CA 91316-1516
Phone (818) 468-5599

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

State licenses

LicenseStateTypeSpecialty
PSY 16338CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1538302807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 BALBOA BLVD",
            "address_2": "SUITE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161516",
            "telephone_number": "818-468-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 BALBOA BLVD",
            "address_2": "SUITE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161516",
            "telephone_number": "818-468-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEN",
        "first_name": "SHERYL",
        "middle_name": "MANDELA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 16338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; 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.