Individual provider Active NPI

Lauren Logan

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1568657971
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26344 Issued in CA
Practice address
1625 Schrader Blvd
Los Angeles, CA 90028
Phone
(323) 993-8953
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY26344 CA Primary

Addresses

Primary practice location

1625 Schrader Blvd
Los Angeles, CA 90028

Mailing address

10802 College PL
Cerritos, CA 90703-1505

Other practice location 1

11825 Major St
Culver City, CA 90230-6356
Phone (323) 282-5753

Other identifiers 1

IdentifierTypeStateIssuer
953421289OtherCAMEDICARE AND MEDICAL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171221002062 CA Practitioner - Clinical Psychologist 8921366857 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26344CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles LGBT Center CurrentSince Apr 24, 2018 Accepting new patients
Los Angeles LGBT Center CurrentSince Apr 24, 2018 Accepting new patients
Best Me Psychotherapy, Inc. Clinical CurrentSince Nov 13, 2017 Accepting new patients

Locations

11825 Major St
Ste 207
Culver City, CA 90230
Phone (323) 271-1600

11825 Major St
Ste 106
Culver City, CA 90230
Phone (323) 271-1600

1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400

1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1568657971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 COLLEGE PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90028",
            "telephone_number": "323-993-8953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11825 Major St",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902306356",
            "country_code": "US",
            "telephone_number": "323-282-5753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE AND MEDICAL",
            "identifier": "953421289",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.