Individual provider Active NPI

Nikki Rubin, PSY.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1558537639
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019595 Issued in NY
Practice address
11500 W Olympic Blvd Ste 460
Los Angeles, CA 90064-1562
Phone
(310) 933-4198
Fax
(310) 933-4198
NPI assigned
May 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 019595 NY Primary

Addresses

Primary practice location

11500 W Olympic Blvd Ste 460
Los Angeles, CA 90064-1562

Mailing address

11500 W Olympic Blvd Ste 460
Los Angeles, CA 90064-1562
Phone (310) 933-4198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 17, 2019 through Jul 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30047CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nikki Rubin, Psy.D., a Psychological Corporation Current Accepting new patients
Dr Robert L Leahy Psychologist PC Dba American Institute for Cognitiv Clinical Past Accepting new patients

Locations

11500 W Olympic Blvd
Ste 460
Los Angeles, CA 90064
Phone (310) 933-4198

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1558537639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD STE 460",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641562",
            "telephone_number": "310-933-4198",
            "fax_number": "310-933-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD STE 460",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641562",
            "telephone_number": "310-933-4198",
            "fax_number": "310-933-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "NIKKI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-07",
        "last_updated": "2025-09-11",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.