Marjan Smith Madison, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY18126 Issued in CA

Practice address

9107 Wilshire Blvd
Suite 200
Beverly Hills, CA 90210-5531

Phone

(310) 275-2212

Fax

(310) 275-2212

NPI assigned

Sep 22, 2015

Last updated

Sep 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1568831386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9107 WILSHIRE BLVD",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105531",
            "telephone_number": "310-275-2212",
            "fax_number": "310-275-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9107 WILSHIRE BLVD",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105531",
            "telephone_number": "310-275-2212",
            "fax_number": "310-275-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "MARJAN",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY18126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Maclennan, CRNA
• Shelly Rebeka Madan
• Kourosh Maddahi, DDS
• Tiffany Maddahi
• Ethan Sean Madison, DDS
• Miles Madison, DDS
• Madkan Dermatology, PC (Mosaic Dermatology)
• Peter Nicholson Maduro, J.D., PSY.D.
• Mafl Medical Inc a Professional Corporation
• Maggie a Carroll MFT PHD

• Psychologist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.